TEE-Guided One-Stage Excision of Intravenous Leiomyomatosis With Cardiac Extension Through an Abdominal Approach
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Leiomyomatosis
Transesophageal echocardiogram
Leiomyomatosis
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Leiomyomatosis
Vena cava
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Transesophageal echocardiogram
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We present an unusual case of benign metastasizing leiomyoma in association with intracaval leiomyomatosis. To our knowledge, this is the first reported case of metastasizing leiomyoma with coexistent intravenous leiomyomatosis (IVL). Magnetic resonance imaging is useful for the diagnosis of pelvic and caval IVL. Benign metastasizing leiomyoma is a rare condition affecting females, characterized by soft tissue tumours at distant sites that are histologi- cally identical to leiomyomas of the uterus. Although this condition is associated with micro- vascular invasion by smooth muscle cells, usually within a uterine leiomyoma, it has not been reported with intravenous leiomyomatosis (IVI) which presents as a macroscopic smooth muscle tumour within the venous system (1-5).
Leiomyomatosis
Uterine Leiomyoma
Smooth Muscle Tumor
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Leiomyomatosis
Palpitations
Uterine Leiomyoma
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Abstract Sudden death resulting from intracardiac leiomyomatosis is rare. In this case, a 50-year-old woman was found to have intracardiac leiomyomatosis, which originated in veins in the broad ligament. Tumor filled the entire inferior vena cava and extended into the right heart where it had embolized and occluded the right main pulmonary artery. The mechanism of death was sudden right heart failure.
Leiomyomatosis
Broad ligament
Sudden Death
Right heart failure
Right heart
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Leiomyomatosis
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Difficulties in the preoperative preparation and surgical management of patients with intravenous leiomyomatosis involving the heart and pulmonary artery resulting in intracardiac leiomyomatosis necessitate further investigation of this condition. In this report, we describe the interdisciplinary treatment of two cases of intracardiac leiomyomatosis with enormous mass in the abdominopelvic cavity. A single-stage surgical procedure with a combined thoracic and abdominal approach was performed in both cases and the tumors were successfully excised. The procedure also involved removal of the atrial, caval and other venular extensions, and total hysterectomy with bilateral salpingo-oophorectomy. Postoperative pathology findings confirmed the diagnosis of intravenous leiomyomatosis. Neither patient died perioperatively, and no complications were observed.
Leiomyomatosis
Thoracic cavity
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Leiomyomatosis
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Intravenous leiomyomatosis is a rare smooth muscle tumor that is associated with uterine leiomyomas. Intravenous leiomyomatosis often presents with nonspecific abdominal and cardiac symptoms, making the diagnosis difficult. We present a comprehensive review of a case of a 52-year-old woman with intravenous leiomyomatosis with intracardiac extension, who was successfully treated with complete surgical resection.
Leiomyomatosis
Surgical resection
Smooth Muscle Tumor
Uterine myomectomy
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