{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T06:57:17Z","timestamp":1767769037132,"version":"3.48.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Radiol."],"abstract":"<jats:p>\n                    Low-grade endometrial stromal sarcoma (LGESS) is a rare uterine malignancy; metastasis to the inferior vena cava (IVC) and right atrium is exceptionally rare and presents significant diagnostic and therapeutic challenges. We report the case of a 37-year-old woman presenting with progressive abdominal mass enlargement, palpitations, and dyspnea. She had undergone a hysteroscopic resection for presumed uterine myoma one year prior, which was subsequently re-evaluated as LGESS. Multimodal imaging comprising\n                    <jats:sup>18<\/jats:sup>\n                    F-FDG PET\/CT, MRI, CT, and echocardiography was implemented for systemic staging and hemodynamic assessment, then revealed a solid uterine mass involving the adnexa (FIGO Stage IVB) and identified hypermetabolic tumor thrombi extending from the IVC into the right atrium and pulmonary arteries. A coordinated one-stage radical resection was performed, involving total hysterectomy and removal of intracardiac thrombi under cardiopulmonary bypass. Postoperative pathology and immunohistochemistry confirmed LGESS (CD10+, ER+, PR+) with extensive lymphovascular invasion. The patient recovered uneventfully with no residual disease on follow-up and commenced adjuvant letrozole therapy. This case highlights the necessity of multimodal imaging for accurate staging of complex vascular involvement and demonstrates that aggressive one-stage surgical management is a viable strategy to achieve locoregional control and favorable early outcomes for advanced LGESS with cardiac metastasis.\n                  <\/jats:p>","DOI":"10.3389\/fradi.2025.1723859","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T06:52:19Z","timestamp":1767768739000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Metastasis of low-grade endometrial stromal sarcoma to the inferior vena cava and right atrium: a case of successful one-stage surgical resection with favorable early outcome"],"prefix":"10.3389","volume":"5","author":[{"given":"Jinglian","family":"Tu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaopei","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengbo","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.ygyno.2013.10.029","article-title":"Prognostic factors and outcomes in endometrial stromal sarcoma with the 2009 FIGO staging system: a multicenter review of 114 cases","volume":"132","author":"Yoon","year":"2014","journal-title":"Gynecol Oncol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1159\/000494225","article-title":"Low-Grade endometrial stromal sarcoma - 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