Intracaval Leiomyoma with Intracardiac ExtensionFunding None.
The objective of this study was to explain step by step how to achieve a complete resection of an intravascular leiomyoma. A 48-year-old woman was referred to our institution with progressive dyspnea on exertion, lightheadedness, and previous history of total abdominal hysterectomy and bilateral salpingo-oophorectomy for a uterine leiomyoma echocardiography, computed tomography, and magnetic resonance imaging of the heart and abdomen/pelvis were performed and an intracaval mass with extension into the right heart and pulmonary artery was identified. After multidisciplinary review, a single-stage sternotomy–laparotomy procedure on cardiopulmonary bypass (with beating heart, mild hypothermia, and no deep hypothermic circulatory arrest) ensured complete resection of a giant intravenous leiomyoma (IVL). Multidisciplinary approach, multimodality imaging, and single-stage sternotomy–laparotomy procedure on cardiopulmonary bypass (with heart beating and mild hypothermia) ensure complete resection of IVL.
Keywordsleiomyoma - cardiopulmonary bypass - laparotomy - sternotomy - excision - IVC - thrombosis - resection
Artikel online veröffentlicht:
05. Dezember 2021
© 2022. International College of Angiology. This article is published by Thieme.
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- 1 Li B, Chen X, Chu YD, Li RY, Li WD, Ni YM. Intracardiac leiomyomatosis: a comprehensive analysis of 194 cases. Interact Cardiovasc Thorac Surg 2013; 17 (01) 132-138
- 2 Roques F, Sanchez B, Bucher B, Larivière J. Role of pre-operative assessment in the surgical management of leiomyoma extended to the right heart chambers: a compendium of information from isolated reports. Eur J Cardiothorac Surg 2001; 19 (04) 522-524
- 3 Motwani M, Kidambi A, Herzog BA, Uddin A, Greenwood JP, Plein S. MR imaging of cardiac tumors and masses: a review of methods and clinical applications. Radiology 2013; 268 (01) 26-43
- 4 Marrone G, Crinò F, Morsolini M, Caruso S, Miraglia R. Multidisciplinary approach in the management of uterine intravenous leiomyomatosis with intracardiac extension: case report and review of literature. J Radiol Case Rep 2019; 13 (07) 1-13
- 5 Lam PM, Lo KW, Yu MY. et al. Intravenous leiomyomatosis: two cases with different routes of tumor extension. J Vasc Surg 2004; 39 (02) 465-469
- 6 Gan HL, Zhang JQ, Zhou QW, Kong QY, Zhao S, Bo P. Surgical treatment of intracardiac leiomyomatosis. J Thorac Cardiovasc Surg 2011; 142 (04) 823-828
- 7 Navia JL, Brozzi NA, Nowicki ER. et al. Simplified perfusion strategy for removing retroperitoneal tumors with extensive cavoatrial involvement. J Thorac Cardiovasc Surg 2012; 143 (05) 1014-1021
- 8 Doyle MP, Li A, Villanueva CI. et al. Treatment of intravenous leiomyomatosis with cardiac extension following incomplete resection. Int J Vasc Med 2015; 2015: 756141