Large left upper quadrant mass

Thromboembolism disease is a major cause of morbidity and mortality in pregnancy. Several cases have reported the successful use of tissue plasminogen activator (t-PA) in massive pulmonary embolism (PE) in pregnancy. However, it is still considered as an experimental treatment. We report the case of the successful thrombolysis by recombinant t-PA of a massive PE in a pregnant woman associated with the use of a retrievable vena cava filter. A 33-year-old woman presented at 31 weeks of gestation with dyspnea and presyncope. A diagnosis of massive PE was made with the help of Doppler ultrasound and echocardiogram. An inferior vena cava filter was placed percutaneously, and she received 100 mg of intravenous recombinant t-PA. The patient had a minor epistaxis, but recovered rapidly. She delivered a healthy male infant at term. Thrombophilia tests found a G20210A prothrombin (FII) mutation.