Intravenous leiomyomatosis with extension to the heart: echocardiographic features: a case report.
A 40-year-old female was admitted to the hospital for an operation with a presumptive diagnosis of right atrial myxoma. She had had a hysterectomy for leiomyoma 8 months earlier and has since experienced progressive dyspnea on exertion, pedal edema, and two syncope episodes in the past 2 months. Cardiac murmur was detected and two-dimensional echocardiography was arranged. A mobile right atrial mass was discovered, which was thought to be a myxoma. The patient subsequently received open heart surgery. Histologic examination of the resected mass confirmed intravenous leiomyomatosis. Magnetic resonance imaging performed on the eighth postoperative day revealed an intravascular mass from the right common iliac vein to the upper abdominal inferior vena cava. The patient underwent a second operation one and half months after the first operation, with resection of the tumor mass in the inferior vena cava and resection of multiple uterine myoma. She recovered well. Repeat magnetic resonance imaging 6 months following the second operation showed that the inferior vena cava and right atrium were clear of tumor.
Fang
Ber-Ren
BR
Division of Cardiology, Chang Gung Memorial Hospital, and Chang Gung University, College of Medicine, Taiwan, Republic of China. kaec15@ms27.hinet.net
Ng
Yuet-Tong
YT
Yeh
Chi-Hsiao
CH
D006348:Cardiac Surgical Procedures; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D005260:Female; D006325:Heart Atria / Q000473:pathology; D006338:Heart Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007044:Hysterectomy; D007084:Iliac Vein / Q000473:pathology; D018231:Leiomyomatosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009232:Myxoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D019043:Vascular Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D014656:Vascular Surgical Procedures; D014682:Vena Cava, Inferior / Q000473:pathology