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Intracardiac leiomyomatosis: echocardiographic features

I J Kullo1, J K Oh, G L Keeney

  • 1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.

Chest
|February 23, 1999
PubMed

Insights

Intravenous leiomyomatosis, a benign smooth-muscle tumor, can extensively spread to the heart. Echocardiography reveals characteristic masses in the cardiac chambers and pulmonary arteries.

Area of Science:

  • Cardiology
  • Oncology
  • Pathology

Background:

  • Intravenous leiomyomatosis (IVL) is a rare condition characterized by benign smooth-muscle tumors extending through vascular channels.
  • It typically arises from uterine fibroids or uterine vessels, often presenting years after hysterectomy.

Observation:

  • This study describes two middle-aged women with a history of hysterectomy who presented with cardiac symptoms.
  • Echocardiography revealed extensive IVL involving the right-sided cardiac chambers and pulmonary arteries, originating from the inferior vena cava and azygos vein.

Findings:

  • Distinctive echocardiographic findings included elongated, mobile masses within the venous system and heart.
  • Multiple venous attachments and filling of venous vessels and right-heart chambers were observed, indicating tumor spread.

Implications:

  • Intracardiac leiomyomatosis should be considered in the differential diagnosis for women presenting with cardiac masses.
  • Echocardiography is crucial for identifying the extent of IVL within the cardiovascular system and guiding management.

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