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Case Reports
. 2021 Jun 26;2021(6):rjab249.
doi: 10.1093/jscr/rjab249. eCollection 2021 Jun.

Intravascular leiomyomatosis with intracardiac extension: a toraco-abdominal approach

Antonio Miro  1 , Enrico Coppola Bottazzi  1 , Serafino Vanella  1 , Tommaso Palma  1 , Adele Noviello  1 , Ivano Apicella  1 , Giulio Lombardi  2 , Brenno Fiorani  3 , Francesco Crafa  1
Affiliations
Case Reports

Intravascular leiomyomatosis with intracardiac extension: a toraco-abdominal approach

Antonio Miro et al. J Surg Case Rep. .

Abstract

Intravenous leiomyomatosis is a rare nonmalignant tumor, which originates from the uterine smooth muscle cells and is usually confined to the pelvic venous system. Sometimes it can extend from the pelvis through the veins into the right side of the heart; this condition is named intracardiac leiomyomatosis (ICLM). To date few cases of these conditions have been described, the treatment is surgical, often challenging and usually multidisciplinary. In this paper are described the clinical presentation, the full radiologic study and surgical treatment of a case of ICLM that authors treated at their institution with thoraco-abdominal approach. Surgical removal of the ICLM is strongly recommended, because no recurrence has been reported, in our case at 7 years we did not observe recurrence of the disease.

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Figures

Figure 1
Figure 1
CT scan images (A–B) arterious phase showing the defect inside right atrium (yellow arrow) and intrahepatic inferior vena cava (white arrow) due to the presence of the intravascular leimyoma. (C–D) vascular CT reconstruction of the ovarian veins (red arrow), inferior vena cava (white arrow) and right atrium (yellow arrow) stored with the intravascular leiomyoma. (E) Particular view of the ovarian veins (red arrow) with the origin from the right uterine aspect.
Figure 2
Figure 2
MRI view (A) right atrium with the intravascular leiomyoma prolapsing into the right ventricle (yellow arrow) (B) intrahepatic inferior vena cava stored with the intravascular leiomyoma (white arrow).
Figure 3
Figure 3
The surgical and pathological aspect of the extracted specimen.
See this image and copyright information in PMC

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