Endoscopic tumor resection of the inferior vena cava.

A51-year-old woman was referred for evaluation of an asymptomatic systolic murmur. Transthoracic echocardiography showed a large right atrial (RA) mass with intermittent prolapse through the tricuspid valve and extending into the pulmonary artery. On the preoperative transesophageal echocardiographic examination, a tumor with multiple strands was seen. One strand intermittently obstructed the outflow of the hepatic vein (Figure 1). There was apparent obstruction of the RA inflow and right ventricular inflow and outflow tracts by another strand.