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Published on: April 17, 2020
Intravenous leiomyomatosis with intracardiac extension: a single-institution experience
Micheal J Worley1, Anate Aelion, Thomas A Caputo
1Department of Obstetrics and Gynecology, New York Presbyterian Hospital-Weill-Cornell Medical College, New York, NY, USA.
Insights
Surgical management of intravenous leiomyomatosis with intracardiac extension is effective. Despite incomplete resection in most cases, all patients remained recurrence-free, indicating favorable outcomes.
Area of Science:
- Cardiovascular Surgery
- Gynecologic Oncology
- Pathology
Background:
- Intravenous leiomyomatosis (IVL) is a rare benign smooth muscle tumor characterized by vascular invasion.
- Intracardiac extension of IVL presents significant surgical and management challenges.
- Limited data exists on the surgical outcomes for IVL with intracardiac extension.
Purpose of the Study:
- To describe the surgical management and outcomes of patients with IVL and intracardiac extension.
- To evaluate the efficacy of surgical intervention in this specific patient cohort.
Main Methods:
- Retrospective review of patients diagnosed with IVL with intracardiac extension between 2002 and 2008.
- Analysis of surgical approaches, presenting symptoms, resection status, and follow-up data.
Main Results:
- Four patients were identified with IVL and intracardiac extension.
- All patients presented with cardiac symptoms, including syncope.
- Complete tumor resection was achieved in 25% of patients; incomplete resection in 75%.
- Despite incomplete resection in most cases, all patients were recurrence-free at a mean follow-up of 25.5 months.
Conclusions:
- Surgical excision is an effective treatment for benign metastasizing leiomyomatosis with intracardiac extension.
- Incomplete surgical resection may still lead to favorable outcomes with no recurrence.
Objective:
The aim of this study was to outline the surgical management and outcomes for patients diagnosed with intravenous leiomyomatosis with intracardiac extension at a single institution.
Study Design:
This was a retrospective review of patients diagnosed with intravenous leiomyomatosis with intracardiac extension between 2002-2008.
Results:
Four patients were identified. The surgical approach in 3 (75%) patients was a single-stage operation. Four (100%) patients presented with cardiac symptoms: 3 (75%) with syncope and 1 (25%) with an abnormal electrocardiogram. Mean age at presentation was 48 years (range, 42-58 years). Complete resection of tumor was obtained in 1 (25%) patient and 3 (75%) patients experienced incomplete resection. Mean follow-up, including surveillance imaging, was 25.5 months (range, 8-57 months) and all 4 patients (100%) are currently free of recurrence.
Conclusion:
Surgical excision remains an effective therapy for treating patients with benign metastasizing leiomyomatosis. Incomplete surgical resection may result in favorable response.
