Low-grade endometrial stromal sarcoma (LG-ESS) is a rare uterine malignancy, accounting for less than 1% of all uterine malignancies. And there is no literature reporting about acute obstruction of inferior vena cava (IVC) caused by LG-ESS. In November 2021, A patient diagnosed with LG-ESS was admitted to our hospital, presenting with pitting edema of the right lower limb, menstrual disturbance, nausea, oliguria andincreased serum creatinine. Imaging suggested complete obstruction of IVC cava. This difficult case was successfully treated with staging surgery combined with endocrine therapy by a cooperative multidisciplinary team (MDT). The important role of MDT in the treatment process of such a difficult and serious case was demonstrated.

Nutcracker syndrome (NCS) is a rare disease that may cause proteinuria, renal dysfunction and varicose of genital veins. Traditional open surgery prefers left renal vein transposition, but this surgical method is more traumatic and patients often have more postoperative short-term and long-term complications affecting the quality of life. This article reports a case of a young male patient with NCS complicated with left varicocele. He was treated with left gonadal vein-inferior vena cava transposition and high ligation of spermatic vein, which achieved good results after surgery. This surgical method provides a new treatment idea for patients with NCS and varicocele, which is worthy of clinical reference.