title: Leiomyosarcoma of the inferior vena cava extending into the right atrium. A rare differential diagnosis of a right atrial tumor with fatal outcome.
abstract: A 54-year-old female patient presented with a progressive and deteriorating dyspnea at the slightest exertion in particular during the past few days before presentation. Transthoracic echocardiography revealed a large space-occupying lesion in the right atrium extending into the inferior vena cava (IVC). Abdominal magnetic resonance aortography showed an elongated space-occupying lesion in the IVC with a significant portion of the tumor and almost completely filling the right atrium accompanied by an infiltration of the hepatic and renal veins. A pronounced tumor infiltration of the IVC at the level of the liver was confirmed intraoperatively and immunohistochemical analysis showed a moderate to poorly differentiated leiomyosarcoma. The extended tumor was successfully removed by a complex operation of the thorax and abdomen but the procedure was accompanied by severe bleeding. A few hours following the procedure the patient died due to a further episode of irreversible intra-abdominal hemorrhage.
authors.affiliation: Department of Internal Medicine, DRK Hospital Sondershausen, Hospitalstr. 2, 99706, Sondershausen, Germany. lotze@sdh.drk-tb.de
authors.forename: U
authors.initials: U
authors.lastname: Lotze
authors.forename: J
authors.initials: J
authors.lastname: Reponova
authors.forename: G
authors.initials: G
authors.lastname: Muth
authors.forename: G
authors.initials: G
authors.lastname: Oltmanns
authors.forename: H-C
authors.initials: HC
authors.lastname: Reich
authors.forename: G
authors.initials: G
authors.lastname: Etzrodt
authors.forename: W A
authors.initials: WA
authors.lastname: Kaiser
authors.forename: O
authors.initials: O
authors.lastname: Mutschke
authors.forename: M
authors.initials: M
authors.lastname: Ortmann
authors.forename: D
authors.initials: D
authors.lastname: Stippel
authors.forename: T
authors.initials: T
authors.lastname: Wahlers
mesh_terms: D017809:Fatal Outcome; D005260:Female; D006325:Heart Atria / Q000601:surgery; D006338:Heart Neoplasms / Q000601:surgery*; D006801:Humans; D007890:Leiomyosarcoma / Q000601:surgery*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D014682:Vena Cava, Inferior / Q000601:surgery