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Case Reports
. 2020:77:647-650.
doi: 10.1016/j.ijscr.2020.11.095. Epub 2020 Nov 21.

Cardiac metastasizing leiomyoma: A case report

Raquel Reis Soares  1 , Leonardo Ferber Drumond  2 , Daniel Soares da Mata  3 , Luiza Miraglia Firpe  3 , João Victor Tavares Mendonça Garretto  4 , Matheus Ferber Drumond  5
Affiliations
Case Reports

Cardiac metastasizing leiomyoma: A case report

Raquel Reis Soares et al. Int J Surg Case Rep. 2020.

Abstract

Introduction: Cardiac intracavitary growth of metastasizing tumour is unusual. Benign Metastasizing Leiomyoma (BML) from the uterus to the heart is extremely rare. It affects premenopausal women with a history of uterine leiomyoma.

Presentation of case: We report a case of a 42-year-old woman who presented three tumours in the right side of the heart, two years after a hysterectomy due to leiomyomatosis. The cardiac tumours were resected and the diagnosis was uterine leiomyoma.

Discussion: The patient developed cardiac failure due to three masses at the right side of the heart. Cardiac involvement in BML is usually asymptomatic and rare. The heart masses were surgically removed and a peri ovarian mass was detected and also removed. Although histologically benign, BML exhibits metastatic qualities.

Conclusion: It suggests that BML should be included as a differential diagnosis when a female patient presents an intra cardiac mass and a history of hysterectomy.

Keywords: Benign metastasizing; Cardiac metastasis; Cardiac tumour; Case report; Leiomyoma.

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Figures

Fig. 1
Fig. 1
Right Heart Masses on Echocardiography: (a) long axis parasternal view showing a large mass (arrow) adhered to the right side of the interventricular septum; (b) anteriorly angulated four chamber apical view showing the same mass (arrow); (c) four chamber apical view showing right chambers enlargement and thickening of the tricuspid subvalvar apparatus (arrow); (d) severe tricuspid regurgitation (arrow). LA: left atrium; LV: left ventricle; RA: right atrium; RV: right ventricle.
Fig. 2
Fig. 2
Cardiac magnetic resonance imaging showing a large mass (*) and a smaller one (arrow) inside the RV. DA: descending aorta; LA: left atrium; LVOT: left ventricle outflow tract; PA: pulmonary artery; PE: pericardial effusion; RV: right ventricle.
Fig. 3
Fig. 3
Surgical specimen consisting of 3 pink-tan rubbery masses. A: mass adhered to the tricuspid valve (valve tissue - arrow); B: mass attached to the interventricular septum; C: mass attached to the anterior face of the RVOT.
Fig. 4
Fig. 4
Four chamber apical view showing normal function tricuspid valve prosthesis and RV with systolic function preserved.
See this image and copyright information in PMC

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