[Intravascular leiomyomatosis presenting as a right atrial mass].
BACKGROUND
Intravenous leiomyoma is a peculiar, rare tumour that originates from the myomatous uterus, grows into the lumina of veins and, through the inferior vena cava, may extend to the right heart cavity. The intracardial tumour causes severe cardiovascular symptoms and may be fatal.


METHODS
The symptoms of the 45-year-old woman consisted of chest discomfort, dizziness, and short periods of unconsciousness, which occurred during vacuum-cleaning when she bent forward. Imaging showed a growth that filled the lumen of the vena cava and extended to the right atrium, swinging between the atrium and ventricle. The patient underwent surgery with cardiopulmonary bypass and the intracardial tumour was removed together with its extensions filling the veins. The histological examination verified intravenous leiomyomatosis. Although the patient refused the recommended hysterectomy, she is well after six years the operation.


CONCLUSIONS
In cases of unspecific cardiac symptoms, the possibility of intravenous leiomyomatosis should be considered. The diagnosis can be set up by echocardiography, MR or CT scan. If the diagnosis is confirmed, the tumour should be surgically removed.
Magyar
Eva
E
Országos Gyógyintézeti Központ, Patológiai Osztály, H-1031 Budapest. magyare@ogyik.hu
Salamon
Ferenc
F
Tomcsányi
István
I
D003937:Diagnosis, Differential; D004452:Echocardiography; D005260:Female; D006325:Heart Atria; D006338:Heart Neoplasms / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D018231:Leiomyomatosis / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D019043:Vascular Neoplasms / Q000175:diagnosis* / Q000473:pathology