title: Low-Grade Endometrial Stromal Sarcoma with Intravenous and Intracardiac Extension: A Multidisciplinary Approach.
abstract: Background. A rare case of low-grade endometrial stromal sarcoma (LG-ESS) extending to inferior vena cava (IVC) and cardiac chambers. Case Report. A 40-year-old woman had IVC tumor, which was incidentally detected by abdominal ultrasonography during a routine medical checkup. CT scan revealed a tumor in IVC, right iliac and ovarian veins, which was derived from the uterus and extended into the right atrium and ventricle. The operation was performed, the heart and IVC were exposed, and cardiopulmonary bypass was initiated. A right atriotomy was performed, and the intracardiac mass was removed. Then the tumor in IVC and the right internal iliac vein were removed after longitudinal venotomies in the suprarenal and infrarenal vena cava, the right common iliac vein. Next the pelvis was explored. Tumors were found originating from the posterior wall of the uterus and continuing into both the right uterine and ovarian vein. The patient underwent total hysterectomy with bilateral salpingooophorectomy. Complete tumor resection was achieved. Histopathological analysis confirmed a diagnosis of LG-ESS. She showed no evidence of disease for 2 years and 3 months. Conclusions. Our case highlights the importance of a multidisciplinary approach in treating this rare cardiovascular pathological condition through preoperative assessment to final operation.
authors.affiliation: Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Wataru
authors.identifier: 0000-0002-7600-074X
authors.initials: W
authors.lastname: Kudaka
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Inafuku
authors.affiliation: Department of Radiology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Yuko
authors.identifier: 0000-0002-6845-6392
authors.initials: Y
authors.lastname: Iraha
authors.affiliation: Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Nakamoto
authors.affiliation: Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Taira
authors.affiliation: Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Taira
authors.affiliation: Department of Radiology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Hisashi
authors.identifier: 0000-0003-0214-4860
authors.initials: H
authors.lastname: Kamiya
authors.affiliation: Department of Radiology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Maho
authors.initials: M
authors.lastname: Tsubakimoto
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Totsuka
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Kuniyoshi
authors.affiliation: Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Tamaki
authors.affiliation: Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Aoyama
authors.affiliation: Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Masanao
authors.identifier: 0000-0001-8297-7226
authors.initials: M
authors.lastname: Saio
authors.affiliation: Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Naoki
authors.identifier: 0000-0002-4670-3372
authors.initials: N
authors.lastname: Yoshimi
authors.affiliation: Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Yoichi
authors.identifier: 0000-0003-3545-8639
authors.initials: Y
authors.lastname: Aoki