Superior Vena Cava Syndrome associated with recurrent uterine adenosarcoma

•A woman with a history of Stage IA low-risk uterine adenosarcoma presented with shortness of breath and rib pain.•She was found to have recurrent metastatic disease with resultant fatal SVC Syndrome.•Better methods to determine which patients with uterine adenosarcoma are at risk of recurrence and death are needed.