[HSF] IVC Mass

[Mark Levinson]

On Nov 29, 2007, at 8:44 PM, Edward Bender wrote:

> I know that this isn't a cardiac case, but I wanted to see if this  
> mass in the IVC is familiar to any of the members.
> This is a healthy, asymptomatic 22 year old female radiology tech  
> student who was playing around with the ultrasound machine.  She  
> found a filling defect in her IVC and asked one of the radiologists  
> about it.  She then underwent a CT angio which is composited below.  
> The renal veins and iliac veins are without filling defect.  She  
> had venous doppler studies of the lower extremities which are  
> normal.  She had an echocardiogram which is normal.  She has no  
> symptoms whatsoever.  She does take oral contraceptives but does  
> not smoke.  She has never had any injuries major illnesses, etc.
>
> I don't understand why she should have this filling defect, and,  
> doing a literature/x-ray search, the only thing that looks like  
> this is a leiomyosarcoma.  If anyone has seen a case like this, I  
> would appreciate some incite into differential diagnosis (beyond  
> thrombus and sarcoma), best means of diagnosis, and appropriate  
> treatment.
>
>

Could you get a piece of this with a cardiac biopsy forceps.   I  
worry about a hemangiosarcoma, but I bet its
more likely thrombus attached to the wall.....

Maybe a two month trial of warfarin.   If still there, then  
transvenous biopsy under ultrasound guidance (easier said
than done!)

Mark Levinson, MD.
Founder, Editor-in-Chief
The Heart Surgery Forum®
Multimedia Cardiothoracic Journal
URL: http://www.hsforum.com
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Emali:  mmlevinson at hsforum.com