Erschienen in:
01.08.2012 | Case study
Leiomyosarcoma of the inferior vena cava extending into the right atrium
A rare differential diagnosis of a right atrial tumor with fatal outcome
verfasst von:
PD Dr. U. Lotze, J. Reponova, G. Muth, G. Oltmanns, H.-C. Reich, G. Etzrodt, W.A. Kaiser, O. Mutschke, M Ortmann, D. Stippel, T. Wahlers
Erschienen in:
Herz
|
Ausgabe 5/2012
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Abstract
A 54-year-old female patient presented with a progressive and deteriorating dyspnea at the slightest exertion in particular during the past few days before presentation. Transthoracic echocardiography revealed a large space-occupying lesion in the right atrium extending into the inferior vena cava (IVC). Abdominal magnetic resonance aortography showed an elongated space-occupying lesion in the IVC with a significant portion of the tumor and almost completely filling the right atrium accompanied by an infiltration of the hepatic and renal veins. A pronounced tumor infiltration of the IVC at the level of the liver was confirmed intraoperatively and immunohistochemical analysis showed a moderate to poorly differentiated leiomyosarcoma. The extended tumor was successfully removed by a complex operation of the thorax and abdomen but the procedure was accompanied by severe bleeding. A few hours following the procedure the patient died due to a further episode of irreversible intra-abdominal hemorrhage.