After reconstruction of the IVC, the patient showed good tolerance to gemcitabine and docetaxel.[2] On this basis, we highlighted a clinical female case of intimal sarcoma of IVC with extension to the right atrium and bilateral renal veins, accompanied by multiple intrapulmonary metastasis, which is the first case reporting the effectiveness of tislelizumab combined with GT chemotherapy (gemcitabine injection + docetaxel) for PD-L1-positive IVC intimal sarcoma complicating TP53 mutation. Here, TP53 is linked to intimal sarcoma.