title: Obstructive shock in a 47 year old female with a deep venous thrombosis due to intravascular leiomyomatosis: a case report.
abstract: BACKGROUND
  Intra cardiac tumours and tumour thrombi can present in a manner resembling a massive pulmonary embolism. Intravascular leiomyomatosis with intracardiac extension is one such rare tumour. Survival from obstructive shock in this condition has not been previously reported.
  
  
  METHODS
  A case is presented of a female who presented with recurrent syncope, cyanosis and then circulatory shock. An intravascular and intracardiac mass was suspected. Due to refractory shock, she ultimately underwent single stage median sternotomy and exploratory laparotomy, with excision of an intravascular leiomyoma.
  
  
  CONCLUSIONS
  Intravascular leiomyoma with intracardiac extension should be suspected in the differential diagnosis of a female with a history of uterine fibroids or hysterectomy and presenting with right heart obstructive symptoms.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, New York Presbyterian Hospital-Weill Cornell Medical College 520 East 70 Street, Starr 505, New York, NY 10021 USA. mab9177@med.cornell.edu
authors.forename: Marcus William
authors.initials: MW
authors.lastname: Butler
authors.forename: Abraham
authors.initials: A
authors.lastname: Sanders