Low-Grade Endometrial Stromal Sarcoma with Florid Intravenous Component

Lo, KW; Yu, Mei‐Yung; Cheung, Tak‐Hong

doi:10.1159/000113895

Cited by 9 publications

(11 citation statements)

References 41 publications

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“…These emboli are mainly thrombotic and less frequently tumorous . However, PE occasionally exhibits both components, and such cases are termed pulmonary tumor thromboembolism (PTTE) . Most reported cases in the English language literature occurred after a cancer diagnosis, either before or after operative treatment of the cancer .…”

mentioning

confidence: 99%

Inferior Vena Cava Tumor Thrombosis Secondary to Metastatic Uterine Cancer: A Rare Cause of Sudden Unexpected Death

Srettabunjong

Chuangsuwanich

2016

Journal of Forensic Sciences

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Pulmonary tumor thromboembolus (PTTE) secondary to uterine cancer is a rare cause of sudden unexpected deaths in the elderly population. Additionally, tumor extension to the inferior vena cava (IVC) makes it rarer. No such cases have been previously reported in the forensic literature. We report this phenomenon in a previously healthy 70-year-old woman with no other known risk factors for the development of deep vein thrombosis. The deceased was found dead while watching television with her relatives. Autopsy examination revealed that her death was attributed to a saddle embolus lodged in the main pulmonary arteries. A uterine tumor was discovered, and microscopic examination revealed low-grade endometrial stromal sarcoma with angiolymphatic invasion. The tumor cells were also found in the embolus and the remnant thrombosis attached to the inner wall of the IVC. This case demonstrates a sudden unexpected death caused by acute PTTE following seeding of uterine cancer into the IVC and raises awareness of such events.

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confidence: 99%

Inferior Vena Cava Tumor Thrombosis Secondary to Metastatic Uterine Cancer: A Rare Cause of Sudden Unexpected Death

Srettabunjong

Chuangsuwanich

2016

Journal of Forensic Sciences

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“…This was rather fortunate, as fatal congestive heart failure may be the initial presentation (8,20). In this case, elevation of serum liver enzymes was most likely caused by another reason, since it persisted even after tumor removal.…”

Section: Discussionmentioning

confidence: 82%

“…The key educational point of this case is that, although CT is widely performed, it is important to acknowledge the limitations of this method. It was previously reported that >50% of intravenous LG-ESS cases exhibited ICE (8). In such cases, the extent of the tumor should be determined using modalities such as MRI and ultrasonography, in addition to CT. MRI provides good soft tissue resolution and helps to distinguish an intravascular tumor from a non-tumor thrombus (16)(17)(18), whereas Doppler ultrasonography is also useful (16).…”

Section: Discussionmentioning

confidence: 99%

“…The number of reported cases of LG-ESS with clinically obvious intravascular extension was only 19 over the last 38 years (8,9); however, up to one-third of the cases presented with extrauterine extension, including microscopic worm-like plugs within the vessels (4). Such tumors must be differentiated from deep venous thrombosis, whereas benign leiomyoma presents with characteristics similar to intravenous leiomyomatosis.…”

Section: Introductionmentioning

confidence: 99%

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Intravenous low-grade endometrial stromal sarcoma with intracardiac extension: A CASE OF inaccurate tumor location on contrast-enhanced computed tomography

Nogami

Yamagami

Maki

et al. 2015

Molecular and Clinical Oncology

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Abstract.We herein report a case of low-grade endometrial stromal sarcoma with intracardiac extension in a 58-year-old woman with a uterine tumor with intravascular involvement. The tumor was suspected preoperatively to be an endometrial stromal sarcoma by magnetic resonance imaging. The extent of intravascular involvement was determined to be below the level of the renal veins on preoperative contrast-enhanced computed tomography (CT). However, perioperative echography revealed that the tumor extended to the right atrium. An emergency cardiotomy with extracorporeal circulation was required. The risk of tumor embolism was reduced through transection of the inferior vena cava, but the tumor was difficult to remove completely. Postoperative hormonal therapy reduced the size of the residual tumor and no recurrence was detected for 1 year. The preoperative contrast-enhanced CT was unable to detect the free-floating intravascular tumor. This case illustrates a limitation of CT and indicates that accurate determination of the tumor extent for planning a surgical strategy in similar cases should be performed using multiple imaging methods.

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“…Only 22 cases of advanced LG-ESS have been reported in which the great vessels were invaded and a tumor of the inferior vena cava (IVC) formed [ 3 – 6 ]. However, earlier studies show that >50% of intravenous LG-ESS cases exhibit intracardiac extension [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Low-Grade Endometrial Stromal Sarcoma with Intravenous and Intracardiac Extension: A Multidisciplinary Approach

Kudaka

Ichikawa

Iraha

et al. 2016

Case Reports in Obstetrics and Gynecology

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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.

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Low-Grade Endometrial Stromal Sarcoma with Florid Intravenous Component

Cited by 9 publications

References 41 publications

Inferior Vena Cava Tumor Thrombosis Secondary to Metastatic Uterine Cancer: A Rare Cause of Sudden Unexpected Death

Inferior Vena Cava Tumor Thrombosis Secondary to Metastatic Uterine Cancer: A Rare Cause of Sudden Unexpected Death

Intravenous low-grade endometrial stromal sarcoma with intracardiac extension: A CASE OF inaccurate tumor location on contrast-enhanced computed tomography

Low-Grade Endometrial Stromal Sarcoma with Intravenous and Intracardiac Extension: A Multidisciplinary Approach

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