This paper reports successful combined cytoreductive surgical intervention on a patient with giant recurrent uterine leiomyosarcoma complicated by tumour thrombosis of left ovarian and left renal veins and inferior vena cava. After the comprehensive examination confirmed good prospects for conservative therapy, surgery was performed on 07.02.12 including laparotomic resection of the giant tumour from the abdominal cavity and small pelvis, sigmoid and rectal resection, formation of end-to-end descendorecto-anastomosis, left-hand nephrectomy, removal of tumour thrombus from the suprarenal part of inferior vena cava. The postoperative period was uneventful. No signs of pulmonary thromboembolism were recorded intra- and postoperatively. Wound healing occurred by primary intention, the sutures were removed on day 12 after surgery. The patient was discharged to be further treated on an outpatient basis. Pathological changes in the lower limbs were absent. The patient recovered and leads an active lifestyle. The follow-up examination (July 2012, March 2014) confirmed her healthy status and the absence of signs suggesting the risk of relapse and progress of the neoplastic process.