Key result
Transvenous biopsy identifies a presumed caval thrombus as an endometrial stromal sarcoma requiring surgical excision.
Case Report (n=1)
This case highlights the rarity of malignancy masquerading as caval thrombus and the importance of multispecialty collaboration and biopsy when endovascular removal is recalcitrant.
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.
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Nghiem et al. (2015) conducted a case report in Endometrial stromal sarcoma metastatic to the inferior vena cava and right atrium (n=1). Surgical excision, hysterectomy, and salpingo-oophorectomy was evaluated. Intraprocedural transvenous biopsy revealed a presumed recalcitrant caval thrombus to be an intravascular extension of an endometrial stromal sarcoma, which was subsequently surgically excised.
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