Radical surgery for endometrial stromal sarcoma extending to right atrium

Tumor thrombus presents with nonspecific clinical signs and is diagnosed at advanced stages for this reason. Complete surgical removal of the involved part is the only definitive treatment option. The traditional surgical limitations are imposed by the extent of the thrombus especially when involving the intracardia. Herein, we share the experience of surgical challenges with an extremely extensive disease to provide guidance. The described case is of a tumor thrombus initially misdiagnosed as deep vein thrombosis. The tumor thrombus eventually propagated to the right atrium. The patient underwent inferior vena cava (IVC) resection and complete removal of intracardial tumor thrombus under extracorporeal circulation at advanced stages. A multimodal diagnostic approach is important in cases with extremely advanced stage. Aggressive treatment plays a significant role in improving the patient's life and quality of life.