Korean J Obstet Gynecol.  2012 Jan;55(1):64-68. 10.5468/KJOG.2012.55.1.64.

A case of intravascular leiomyomatosis extending to inferior vena cava, right heart, and pulmonary artery

• Lee JS
• Yoon JW
• Lee KH
• Jung SH
• Ryu YJ
• Park JY

• KMID: 1836768
• DOI: http://doi.org/10.5468/KJOG.2012.55.1.64

Abstract

Intravascular leiomyomatosis is a rare entity of benign smooth muscle tumor invading into the lumen of veins. Although these tumors are histologically benign they sometimes extend into the cardiac cavity and can cause sudden death due to their incarceration into the artrioventricular orifice. We present a case of the intravascular leiomyomatosis originating from huge leiomyoma in the pelvic cavity and extending to the ovarian veins, the inferior vena cava, the right atrium, the right ventricle and the pulmonary artery. She underwent surgery by a single-stage o including laparotomy and venotomy without thoracotomy, and the tumor was successfully removed. Therefore, we report this case with a brief review of the literature.

Keyword

Intravascular leiomyomatosis; Heart extension; Single-stage operation

MeSH Terms

Death, Sudden
Heart
Heart Atria
Heart Ventricles
Laparotomy
Leiomyoma
Leiomyomatosis
Pulmonary Artery
Smooth Muscle Tumor
Thoracotomy
Veins
Vena Cava, Inferior

Figure

• 

  Fig. 1 (A) Abdominal computed tomography (CT) showing mass (arrow) in the abdominal cavity. (B) Abdominal CT showing mass in the inferior vena cava. (C) Chest CT showing mass on right atrium and main pulmonary artery.

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  Fig. 2 (A) Huge mass extened to the right ovarian vein, the inferior vena cava, the right atrium and the pulmonary artery. The inferior vena cava is dilated as a 5 cm diameter. (B) Satinsky clamp grasp the inferior vena cava during repairing.

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  Fig. 3 (A) Intravenous leiomyomatosis. Intracaval worm-like, white mass, measuring 27 cm in length and abdominal mass, measuring 15 × 10 × 7 cm. (B) The resected tumor shows well develped and dilated blood vessels and is mixed cellular and acellular region (H&E, ×12.5). (C) A densely proliferation of small spindle cells with elongated nuclei (H&E, ×400).

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