[HSF] IVC Mass

[john pj]

  we recently had a patient referred to us as ?RA myoma ? RA Thrombus[7*8 cm ]  extending into IVC. CT scan chest done to asess rt lower lobe collapse showed  Hepatoma extending in to rt atrium.

Mark Levinson <mmlevinson at hsforum.com> wrote:
  
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
URL: http://newoptionsinheartsurgery.com
Emali: mmlevinson at hsforum.com

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