A 68-year-old white female presented with two years of progressively worsening dyspnea. Echocardiography revealed a large right atrial mass and partial obstruction of the inferior vena cava. Further imaging revealed a cystic dense mass in the inferior vena cava and right atrium. Immunohistochemical stains were consistent with leiomyosarcoma. Intraoperatively, the tumor was noted to originate from the posterior aspect of the inferior vena cava. The patient underwent successful resection of the mass. Adjuvant radiation therapy was completed. The patient's dyspnea gradually improved and she continues to remain disease free five years post-resection.
History A 65-year-old male patient with a history of sarcomatoid renal cell carcinoma and prior right nephrectomy developed recurrent disease adjacent to the inferior vena cava. The patient underwent surveillance imaging 7 months after initiation of treatment with maximum-dose pazopanib and less than 1 month after completing a 2-month regimen of palliative stereotactic body radiation therapy to the right nephrectomy bed and site of recurrence. (Stereotactic body radiation therapy was initiated 5 months after pazopanib treatment was initiated.
This is a case report of a 54-year-old patient with hepatocellular cancer under palliative chemotherapy who admitted with dyspnea on minimal exertion and peripheral oedema over the past 5 days. Echocardiogram revealed a large echogenic mass in the right atrial cavity which did not enhance with intravenous echo contrast agent, and a distended inferior vena cava (IVC) which was occluded by echogenic material with no signs of flow. To distinguish with accuracy if the thrombus was a bland or tumor thrombus, contrast-enhanced Computed Tomography (CT) was performed.
Background: Inferior vena cava agenesis (IVCA) is a rare vascular abnormality characterised by the absence of one or more segments of the inferior vena cava and represents an underestimated cause of deep vein thrombosis (DVT). Given the very low prevalence of this condition and the lack of clinical trials, there is no consensus about the optimal anticoagulation strategy in IVCA-associated DVT.
Objectives: To investigate efficacy and safety of direct oral anticoagulants (DOACs) in IVCA-associated DVT.
Context: Adrenal venous sampling (AVS) is recommended for subtyping primary aldosteronism (PA), however, it is unreliable when apparent bilateral aldosterone suppression (ABAS) occurs, defined as aldosterone/cortisol ratio in the adrenal vein being bilaterally lower than that in the inferior vena cava. The value of Liquid chromatography-tandem mass spectrometry (LC-MS/MS) in PA subtyping when ABAS occurs is unclear.
Objective: To determine whether LC-MS/MS can reduce the occurrence of ABAS and misdiagnosis of PA subtyping.
Background: Pediatric germ cell tumor (GCT) with extensive cavo-atrial tumor thrombus presenting as an oncologic emergency is extremely rare.
Observation: A 13-month-old female child with sacrococcygeal GCT having inferior vena cava (IVC) and right atrial thrombus presenting with anasarca and respiratory distress is reported. Because of worsening symptoms post initiation of chemotherapy, tumor thrombus debulking from the right atrium and distal end of IVC was performed on day 9 on an emergency basis.
