PMC7500974_01
(
A
) A CT (computed tomography) scan from case A is shown. The volume of the uterus is significantly enlarged and complicated with multiple uterine fibroids. Multiple masses are extending into the right ovarian vein and the inferior vena cava (IVC) and right atrium (RA). An enhanced vascular shadow can be seen in the lesion (
green arrow
). (
B
) A magnetic resonance imaging (MRI) from case B shows multiple uterine fibroids. The tumor extends from the IVC to the RA. The tumor could be observed moving with the movement of the RA. The distal portion of the tumor traverses the tricuspid valve into the RV during diastole. (
C
) The MRI from case C indicates a large, multilobulated, complex pelvic mass closely related to the uterus. The uterus deviates left due to pressure. The mass extends from the right internal iliac vein and the common iliac vein and extends into the IVC and RA (
red arrow
); RV (brown arrow); mass (pink arrow); IVC (yellow arrow); Right ovarian vein (blue arrow); Right common iliac vein (white arrow); Left common iliac vein (orange arrow); Right internal iliac vein (purple arrow); Uterine fibroids (black arrow).
10-1055-s-0040-1715183-i200358crc-1.jpg
PMC7500974_03_10-1055-s-0040-1715183-i200358crc-1.jpg
FI200358crc-1
MRI of the chest and abdomen revealed a cordlike mass extending from the right internal iliac vein into right the common iliac vein, then the IVC, and, finally, the RA ( Fig. 1C ). 
PMC7500974_02
(
A
) A CT (computed tomography) scan from case A is shown. The volume of the uterus is significantly enlarged and complicated with multiple uterine fibroids. Multiple masses are extending into the right ovarian vein and the inferior vena cava (IVC) and right atrium (RA). An enhanced vascular shadow can be seen in the lesion (
green arrow
). (
B
) A magnetic resonance imaging (MRI) from case B shows multiple uterine fibroids. The tumor extends from the IVC to the RA. The tumor could be observed moving with the movement of the RA. The distal portion of the tumor traverses the tricuspid valve into the RV during diastole. (
C
) The MRI from case C indicates a large, multilobulated, complex pelvic mass closely related to the uterus. The uterus deviates left due to pressure. The mass extends from the right internal iliac vein and the common iliac vein and extends into the IVC and RA (
red arrow
); RV (brown arrow); mass (pink arrow); IVC (yellow arrow); Right ovarian vein (blue arrow); Right common iliac vein (white arrow); Left common iliac vein (orange arrow); Right internal iliac vein (purple arrow); Uterine fibroids (black arrow).
10-1055-s-0040-1715183-i200358crc-1.jpg
PMC7500974_03_10-1055-s-0040-1715183-i200358crc-1.jpg
FI200358crc-1
MRI of the chest and abdomen revealed a cordlike mass extending from the right internal iliac vein into right the common iliac vein, then the IVC, and, finally, the RA ( Fig. 1C ). 
PMC7500974_03
(
A
) A CT (computed tomography) scan from case A is shown. The volume of the uterus is significantly enlarged and complicated with multiple uterine fibroids. Multiple masses are extending into the right ovarian vein and the inferior vena cava (IVC) and right atrium (RA). An enhanced vascular shadow can be seen in the lesion (
green arrow
). (
B
) A magnetic resonance imaging (MRI) from case B shows multiple uterine fibroids. The tumor extends from the IVC to the RA. The tumor could be observed moving with the movement of the RA. The distal portion of the tumor traverses the tricuspid valve into the RV during diastole. (
C
) The MRI from case C indicates a large, multilobulated, complex pelvic mass closely related to the uterus. The uterus deviates left due to pressure. The mass extends from the right internal iliac vein and the common iliac vein and extends into the IVC and RA (
red arrow
); RV (brown arrow); mass (pink arrow); IVC (yellow arrow); Right ovarian vein (blue arrow); Right common iliac vein (white arrow); Left common iliac vein (orange arrow); Right internal iliac vein (purple arrow); Uterine fibroids (black arrow).
10-1055-s-0040-1715183-i200358crc-1.jpg
PMC7500974_03_10-1055-s-0040-1715183-i200358crc-1.jpg
FI200358crc-1
MRI of the chest and abdomen revealed a cordlike mass extending from the right internal iliac vein into right the common iliac vein, then the IVC, and, finally, the RA ( Fig. 1C ). 
The gross specimen and tumor extensions are shown. Panels A to C represent cases A to C, respectively. RA (red arrow); IVC (yellow arrow); Right ovarian vein (blue arrow); Right common iliac vein (white arrow); Left common iliac vein (orange arrow); Uterine fibroids (black arrow).
10-1055-s-0040-1715183-i200358crc-2.jpg
PMC7500974_03_10-1055-s-0040-1715183-i200358crc-2.jpg
FI200358crc-2
The gross morphology for each tumor is shown in Fig. 2 .