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Endometrial Stromal Sarcoma Metastatic from the Uterus to the Inferior Vena Cava and Right Atrium
Authors:Daniel Scher  William Nghiem  Salim Aziz  Rodeen Rahbar  Whitney Banks  Anthony Venbrux  Shawn Sarin
Abstract:Endometrial stromal sarcoma metastases usually occur within the pelvis and rarely involve the great vessels or the heart. We present the case of a 55-year-old woman who was referred for endovascular therapy to treat presumed thrombosis of the inferior vena cava. The suspected thrombus was recalcitrant to endovascular removal with use of an AngioVac venous drainage device. Results of an intraprocedural transvenous biopsy revealed the mass to be the intravascular extension of an endometrial stromal sarcoma. The patient underwent surgical excision of the tumor, and, shortly thereafter, a hysterectomy and salpingo-oophorectomy. This complex case highlights both the rarity of malignancy masquerading as caval thrombus and the importance of multispecialty collaboration.
Keywords:Heart atria/surgery   heart neoplasms/secondary/surgery   neoplasm invasiveness   sarcoma   endometrial stromal/complications/diagnosis/pathology/surgery   treatment outcome   uterine neoplasms/pathology   vascular access devices   vena cava   inferior/pathology/surgery
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