Abstract Leiomyosarcoma of the inferior vena cava (IVCL) is a rare retroperitoneal tumor. We report two cases of level II (middle level. renal veins to hepatic veins) IVCL. who underwent en bloc resection with reconstruction of bilateral or left renal venous return using prosthetic grafts. https://www.roneverhart.com/Oakley-Sutro/