Description
A 40-year-old woman under investigation for a pelvic mass presented following a syncopal episode. A large fibroid-like pelvic mass and venous thrombus, extending from the left gonadal vein into the inferior vena cava and right atrium, were noted on CT scan (figures 1 and 2). She was referred to the nearest Sarcoma Unit; single-stage excision was planned.
Figure 1
Thrombus extending up inferior vena cava into the right atrium (superior arrow) with large uterine mass (19.5x16.7x13.7 cm) (inferior arrow).
Figure 2
Thrombus extending up inferior vena cava into the right atrium.
At laparotomy, a 28-week uterus was found. Total abdominal hysterectomy with bilateral salpingo-oophrectomy was performed. The full length of the inferior vena cava and left renal vein were exposed while median sternotomy was undertaken. Following aorto-atrial cannulation, the patient was cooled to 18°C...
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