Intracardiac extension of a calcified ovarian hemangioma--a case report
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C Tamburino1, G Russo, C Incognito
1Department of Cardiology, University of Catania, Italy.
Insights
A rare case of right atrial myxoma in a woman was successfully treated. The tumor, originating from the ovarian vein, was removed via extracorporeal circulation.
Area of Science:
- Cardiology
- Vascular Surgery
- Gynecologic Oncology
Background:
- Right atrial myxomas are rare primary cardiac tumors, often presenting with embolic or obstructive symptoms.
- Vascular leiomyomas, though uncommon, can occur in pelvic veins and rarely extend into the cardiovascular system.
- This case highlights an unusual presentation of a pelvic vascular tumor with intracardiac extension.
Observation:
- A 55-year-old woman presented with clinical and echocardiographic findings suggestive of a right atrial myxoma.
- Fluoroscopy and phlebography revealed a mobile, calcified peduncle originating from the left ovarian vein, traversing the inferior vena cava to the right atrium.
- The mass extended into the right ventricle during diastole, indicating significant intracardiac involvement.
Findings:
- Surgical removal of the right atrial mass and its peduncle was performed using extracorporeal circulation.
- Histopathological confirmation of a vascular leiomyoma originating from the left ovarian vein was obtained.
- Pelvic surgery confirmed the ovarian vein as the primary tumor site.
Implications:
- This case underscores the importance of thorough diagnostic workup to identify the origin of intracardiac masses, even when seemingly originating within the heart.
- It demonstrates the feasibility of surgical management for complex cases involving vascular tumors with intracardiac extension.
- Highlights the multidisciplinary approach required for managing rare cardiovascular and gynecologic conditions.
Abstract:
The authors report a case of a fifty-five-year-old woman with clinical and echocardiographic diagnosis of right atrial myxoma. At fluoroscopy and phlebography a mobile calcified peduncle was appreciable originating from the left ovarian vein. This passed through the inferior cava to the right atrium where it wound round itself and extended into the right ventricle during diastole. The authors suspected the presence of a vascular leiomyoma. The tumor and its peduncle were removed by pulling through the right atrium during extracorporeal circulation. The site of origin was confirmed at pelvic surgery.