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

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Wataru Kudaka ◽  
Hitoshi Inafuku ◽  
Yuko Iraha ◽  
Tomoko Nakamoto ◽  
Yusuke Taira ◽  
...  
Keyword(s):  
Multidisciplinary Approach ◽  
Tumor Resection ◽  
Vena Cava ◽  
Endometrial Stromal Sarcoma ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Histopathological Analysis ◽  
Low Grade ◽  
Stromal Sarcoma ◽  
The Right

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.

scholarly journals Low-Grade Endometrial Stromal Sarcoma with Intravenous and Intracardiac Extension: A Case Report

2020 ◽  
Author(s):  
Xiaoshan Chai ◽  
Hui Ding ◽  
Peng Zhou ◽  
Xilong Mei ◽  
XiaoXue Li ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Right Atrium ◽  
Inferior Vena ◽  
Vena Cava ◽  
Pelvic Mass ◽  
Endometrial Stromal Sarcoma ◽  
Iliac Vein ◽  
Low Grade ◽  
Ki 67 ◽  
Stromal Sarcoma

Abstract Background: Low-grade endometrial stromal sarcoma (ESS) is rare mesenchymal neoplasm, which has an indolent history with late recurrences. ESS usually spread through the lymph nodes and venous system but very seldom involve large vessels or the heart.Case presentation: A 38-year-old Chinese woman was admitted to our department due to pelvic mass found on physical examination. The superior and inferior vena cava CT angiography (CTA) showed an enlarged uterine as well as low density image in the left internal iliac vein, the left common iliac vein, the inferior vena cava, the left renal vein adjacent to the heart and the right atrium, with a range of 110*16mm. The filling defect of right atrium was about 30*14mm. The three-dimensional computed tomography reconstruction showed that the mass originated from the uterine and invaded into the reproductive vein, subsequently extended along the inferior vena cava to the right atrium. Needle biopsy of the pelvic mass was performed and the tissue indicates smooth muscle. The preoperative diagnosis was intravascular leiomyomatosis and the patient underwent radical resection: thrombectomy and total hysterectomy with bilateral salpingo-oophorectomy. Postoperative histopathology revealed low grade endometrial stromal sarcoma. Microscopically, the tumors in both original uterine lesions and intravascular and intracardiac metastases shared morphologic features characterized by neoplastic cells similar to proliferative-phase endometrial stromal cells, in which small spiral artery differentiation was recognized and tumor tissue showed invasive growth pattern by inserting into the surrounding smooth muscle. Immunohistochemistry showed tumor cells were reactive to Estrogen Receptor, Progesterone Receptor,CD10. Primary uterine foci showed cyclin D1(5%+) and Ki-67(20%+),whereas metastatic lesions of the intracardiac and the intravascular component identified cyclin D1(negative) and Ki-67(2%+). The patient is alive without evidence of recurrence 3 months after surgery.Conclusions: Distant metastasis of low-grade endometrial stromal sarcoma is rare, especially involving large vessels or the heart. This case demonstrates that malignant tumor metastasis should be considered as a differential diagnosis of intracardiac and intravascular masses. The treatment rely on multidisciplinary cooperation.

scholarly journals Presentation and management of IVC and iliac vein encroachment by lumbar pedicle screws: a case-report

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Keith George ◽  
Shane Burke ◽  
Sandra Park ◽  
Luis Suarez ◽  
Ron Riesenburger
Keyword(s):  
Multidisciplinary Approach ◽  
Treatment Algorithm ◽  
Vena Cava ◽  
Pedicle Screws ◽  
Operative Management ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vascular Integrity ◽  
The Right ◽  
Case Basis

Abstract Pedicle screws are commonly used in spinal surgeries and are relatively safe, with venous complications occurring rarely. We report a patient with imaging following a L4–5 fusion that showed indentation of the inferior vena cava and right common iliac vein by the right L4 and L5 pedicle screws. She underwent revision surgery in which the hardware was removed and no bleeding was observed. Intraoperative venogram confirmed vascular integrity and absence of indentation on the venous structures following screw removal. The patient recovered without complications. Venous contact by pedicle screws should be treated on a case-by-case basis in a multidisciplinary approach with vascular surgery. We discuss a treatment algorithm for the operative management of this problem.

Iliocaval Compression Syndrome

1987 ◽  
Vol 2 (3) ◽  
pp. 173-179 ◽  
Author(s):  
Syde A. Taheri ◽  
Paul Nowakowski ◽  
David Pendergast ◽  
Julie Cullen ◽  
Steve Pisano ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Common Iliac Artery ◽  
Vena Cava ◽  
Signs And Symptoms ◽  
Iliac Vein ◽  
Venous Hypertension ◽  
Common Iliac Vein ◽  
Compression Syndrome ◽  
Extrinsic Compression ◽  
The Right

The iliocaval compression syndrome is a disorder, frequently found in young women, in which extrinsic compression of the left iliocaval junction produces signs and symptoms of lower extremity venous insufficiency. The anatomic variant which gives rise to this syndrome consists of compression of the left common iliac vein by the overlying right common iliac artery, near its junction with the vena cava. Additional reduction of outflow results from intraluminal venous webs and tight adhesions between the iliac artery and vein. Pain, swelling, pigmentation, and venous claudication characterize this syndrome, which affects predominantly the left leg. The syndrome may progress to iliofemoral thrombosis, phlegmasia cerulea dolens, and venous gangrene. Longstanding iliocaval stenosis may produce valvular incompetence. Exercise plethysmography is a non-invasive test useful in screening patients for iliocaval compression. The definitive diagnosis is made by venography, both ascending and descending, to determine the degree of outflow stenosis. Iliocaval patch angioplasty with retrocaval positioning of the right iliac artery, decreases venous hypertension and leads to improvement in the clinical condition. To date, we have performed iliocaval angioplasty, with retrocaval repositioning of the right common iliac artery, on 18 patients. Of these, 83% have had good results as determined by hemodynamic and clinical assessment.

scholarly journals JAZF1–SUZ12 endometrial stromal sarcoma forming subserosal masses with extraordinary uptake of fluorodeoxyglucose on positron emission tomography: a case report

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Koto Fujiishi ◽  
Shigenori Nagata ◽  
Rieko Kano ◽  
Chiaki Kubo ◽  
Maasa Shirayanagi ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Endometrial Stromal Sarcoma ◽  
Emission Tomography ◽  
Low Grade ◽  
Neoplastic Cells ◽  
Pelvic Magnetic Resonance Imaging ◽  
Stromal Sarcoma ◽  
Positron Emission ◽  
Mesenchymal Neoplasm ◽  
The Right

Abstract Background Low-grade endometrial stromal sarcoma (ESS) is rare mesenchymal neoplasm, recently specified as harboring JAZF1–SUZ12 rearrangement. Typical JAZF1–SUZ12 ESS is slow growing, in which high uptake of fluorodeoxyglucose (FDG) on positron emission tomography (PET) and subserosal masses are quite unusual. Case presentation A 69-year-old Japanese woman complained of urinary incontinence. Pelvic magnetic resonance imaging showed uterine lesions composed of (1) a 9 × 8 × 7-cm mass protruding from the right-anterior wall, (2) a 4.5-cm mass attached to the right-posterior wall, and (3) a 6.5-cm intramural mass in the fundus. FDG-PET demonstrated maximum standardized uptake value of 13.28 confined to the two subserosal masses (1 & 2) in contrast to no uptake of the intramural mass (3). She was diagnosed with a high-grade uterine sarcoma concomitant with leiomyomas and underwent total hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy. The removed uterus had three tumors—two in the right-anterior and right-posterior subserosa, respectively, and the remaining in the fundal myometrium. Microscopically, the three tumors shared morphologic features characterized by neoplastic cells similar to proliferative-phase endometrial stromal cells, in which neither round-cell component, pleomorphism, nor high mitotic activity was recognized. Nuclear cyclin D1 immunostaining was identified 50% of neoplastic cells in the two subserosal tumors (1 &2) whereas < 1% positive cells in the intramural component (3). Reverse transcriptase-polymerase chain reaction showed the same-sized electrophoretic bands indicating JAZF1–SUZ12 gene fusion shared by the three uterine tumors and a focal tumor extension into the extrauterine vein. The patient is alive without evidence of recurrence at 14 months after surgery. Conclusions Pathologists and clinicians should not exclude the possibility of JAZF1–SUZ12 ESS even when uterine subserosal masses demonstrate extraordinary FDG uptake on PET. Molecular analysis is helpful for diagnostic confirmation of JAZF1–SUZ12 ESS with a complex growth pattern.

scholarly journals Low-Grade Endometrial Stromal Sarcoma with Inferior Vena Cava Extension: First Report in Korea

2014 ◽  
Vol 30 (3) ◽  
pp. 98-101 ◽  
Author(s):  
Mi-Hyeong Kim ◽  
Chan-Kwon Jung ◽  
Jeong-Kye Hwang ◽  
In-Sung Moon ◽  
Ji-Il Kim
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Endometrial Stromal Sarcoma ◽  
Low Grade ◽  
First Report ◽  
Stromal Sarcoma

OptEase Retrievable Inferior Vena Cava Filter: Initial Multicenter Experience

Vascular ◽  
2005 ◽  
Vol 13 (5) ◽  
pp. 286-289 ◽  
Author(s):  
David Rosenthal ◽  
James L. Swischuk ◽  
Sidney A. Cohen ◽  
Eric D. Wellons
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena Cava Filter ◽  
Inferior Vena ◽  
Vena Cava ◽  
Iliac Vein ◽  
Vena Cava Filter ◽  
Common Iliac Vein ◽  
Implantation Time ◽  
The Right ◽  
Age Range

The purpose of this article is to describe our experience with the retrievable OptEase inferior vena cava filter (IVCF) (Cordis Corporation, Miami Lakes, FL) in the prevention of pulmonary embolus (PE). Forty patients (24 men, age range 15–85 years, mean age 38 years) who were at temporary risk of PE underwent insertion and retrieval of the OptEase IVCF at two institutions. Eleven patients were treated with filter implantation and subsequent repositioning in the inferior vena cava (IVC) to extend implantation time. All patients were followed up for 24 hours after retrieval, with additional follow-up at the physician's discretion. Forty patients had successful filter insertion. Two patients who underwent intravascular ultrasound guidance for filter deployment required filter repositioning within 24 hours owing to inadvertent placement in the right common iliac vein. All 40 patients underwent successful filter retrieval with no adverse events. In those patients who did not undergo IVCF repositioning, the time to retrieval ranged from 3 to 48 days (mean ± SD 16.38 ± 7.20 days). One patient had a successful retrieval at 48 days, but all other retrieval experiences were performed within 23 days. The second strategy involved implantation, with repositioning at least once before final retrieval. This latter strategy occurred in 11 patients, and the time to first capture ranged from 4 to 30 days (mean ± SD 13.82 ± 6.13 days). No symptomatic PE, IVC injury or stenosis, significant bleeding, filter fracture, or filter migration was observed. In this feasibility study, the OptEase IVCF prevented symptomatic PE, was safely retrieved or repositioned up to 48 days after implantation, and served as an effective bridge to anticoagulation. In patients who require extended IVCF placement, the OptEase IVCF can be successfully repositioned within the IVC, thereby extending the overall implantation time of this retrievable IVCF.

scholarly journals Successful removal of a Gunther tulip vena cava filter with wall-embedded hook and migration during a retrieval attempt

2013 ◽  
Vol 2 (1) ◽  
pp. 1-3
Author(s):  
Takuji Yamagami ◽  
Rika Yoshimatsu ◽  
Tomohiro Matsumoto ◽  
Tsunehiko Nishimura
Keyword(s):  
Inferior Vena ◽  
Vena Cava ◽  
Iliac Vein ◽  
Vena Cava Filter ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Successful Removal ◽  
And Migration ◽  
The Right ◽  
Iliac Vein Thrombosis

Retrieval of a Gunther tulip vena cava filter implanted in a patient with inferior vena cava and right common iliac vein thrombosis was attempted by the standard method. Because the filter was tilted, the hook became attached to the vena cava wall and could not be snared. During attempts at removal by an alternative method, the filter migrated toward the right atrium. However, it was finally successfully removed.

scholarly journals Endometrial Stromal Sarcoma Arising in Colorectal Endometriosis: A Case Report and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Qiao Wang ◽  
Xia Zhao ◽  
Ping Han
Keyword(s):  
Differential Diagnosis ◽  
English Literature ◽  
Tumor Resection ◽  
Endometrial Stromal Sarcoma ◽  
Low Grade ◽  
Review Of The Literature ◽  
Primary Tumors ◽  
Colorectal Endometriosis ◽  
Stromal Sarcoma ◽  
History Of

Extrauterine endometrial stromal sarcoma (ESS) arising in endometriosis is extremely rare, particularly in the colorectum. It should always be included in the differential diagnosis of primary tumors originating from gastrointestinal tract in females, given that preoperative endoscopical biopsy may reveal no specific changes. We reported a case of ESS arising in colorectal endometriosis and reviewed the previous 7 cases reported in the English literature. Our patient, who was unavailable for tumor resection and refused further adjuvant therapy, played a role in representing the natural history of low-grade extragenital ESS. This case was the only death from ESS arising in colorectal endometriosis.

scholarly journals ​Venous anomalies in renal transplantation: an accessory left-sided IVC in a live kidney donor

2019 ◽  
Vol 12 (12) ◽  
pp. e232695
Author(s):  
Jack Whooley ◽  
Atakelet Ferede ◽  
Gordon Smyth ◽  
Dilly Little
Keyword(s):  
Rare Case ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vascular Anomaly ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Kidney Donor ◽  
Left Common Iliac Vein ◽  
Live Kidney Donor ◽  
The Right

Duplication of the inferior vena cava (IVC) resulting in an accessory left-sided IVC is a relatively rare vascular anomaly with a reported prevalence of 0.7%. Radiologically, a duplicated left-sided IVC is usually seen as a continuation of the left common iliac vein, crossing anterior to the aorta at the level of the renal vein to join the right-sided IVC. We present a rare case in which an accessory left-sided IVC was discovered intraoperatively, in a 47-year-old living donor, posing significant intraoperative challenges regarding extraction and subsequent transplantation.

Extensive venous thrombosis and hind-limb edema associated with adrenocortical carcinoma in a dog

1999 ◽  
Vol 35 (4) ◽  
pp. 306-310 ◽  
Author(s):  
MH Jaffe ◽  
AM Grooters ◽  
BP Partington ◽  
AC Camus ◽  
G Hosgood
Keyword(s):  
Venous Thrombosis ◽  
Adrenocortical Carcinoma ◽  
Femoral Vein ◽  
Vena Cava ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Abdominal Ultrasonography ◽  
Mixed Breed ◽  
Limb Edema ◽  
The Right

A 10-year-old, spayed female, mixed-breed dog was referred for evaluation of bilateral hindlimb edema and weakness. Abdominal ultrasonography showed increased echogenicity of the lumen of the caudal vena cava from the level of the urinary bladder to the level of the cranial pole of the right kidney. Bilateral saphenous venograms displayed numerous filling defects in the caudal vena cava, right external iliac vein, right femoral vein, and the right common iliac vein. Extensive venous thrombosis was diagnosed, and the animal was euthanized. Necropsy confirmed the presence of venous thrombosis and revealed a right adrenocortical carcinoma that had invaded the caudal vena cava.

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