title: Endometrial Stromal Sarcoma Metastatic from the Uterus to the Inferior Vena Cava and Right Atrium.
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.
authors.forename: Daniel
authors.initials: D
authors.lastname: Scher
authors.forename: William
authors.initials: W
authors.lastname: Nghiem
authors.forename: Salim
authors.initials: S
authors.lastname: Aziz
authors.forename: Rodeen
authors.initials: R
authors.lastname: Rahbar
authors.forename: Whitney
authors.initials: W
authors.lastname: Banks
authors.forename: Anthony
authors.initials: A
authors.lastname: Venbrux
authors.forename: Shawn
authors.initials: S
authors.lastname: Sarin
mesh_terms: D001706:Biopsy; D003951:Diagnostic Errors; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006325:Heart Atria / Q000473:pathology; D006338:Heart Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010052:Ovariectomy; D010690:Phlebography / Q000379:methods; D011237:Predictive Value of Tests; D058994:Salpingectomy; D018203:Sarcoma, Endometrial Stromal / Q000556:secondary* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D019043:Vascular Neoplasms / Q000556:secondary* / Q000601:surgery; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D020246:Venous Thrombosis / Q000175:diagnosis
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