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Infrarenal transcaval extraction of intracardiac leiomyomatosis
Carlos A Hinojosa1, Heriberto Medina-Franco, Vicente Orozco-Zepeda
1Department of Vascular Surgery and Oncological Surgery, Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán, Mexico City, Mexico. carlos.a.hinojosa@gmail.com
Insights
Intravascular leiomyomatosis, a rare benign tumor, can extend to the heart. This case highlights successful surgical resection in a patient with right ventricular involvement and heart failure.
Area of Science:
- Cardiovascular Medicine
- Gynecologic Oncology
- Vascular Surgery
Background:
- Intravascular leiomyomatosis is a rare neoplastic proliferation of smooth muscle cells originating from the myometrium.
- It characteristically spreads through the venous system, potentially reaching the right heart chambers.
Observation:
- A 39-year-old woman presented with symptoms of heart failure due to intravascular leiomyomatosis with tumor extension into the right ventricle.
- The tumor mass originated from the pelvic vasculature and extended through the inferior vena cava.
Findings:
- Complete surgical resection of the intravascular leiomyomatosis was achieved in a single stage.
- The surgical approach involved infrarenal vena cava tumor resection and hysterectomy.
Implications:
- This case demonstrates the feasibility of radical surgical management for extensive intravascular leiomyomatosis involving the heart.
- Successful surgical outcomes underscore the importance of a multidisciplinary approach in managing this rare condition.
- Reviewing surgical techniques is crucial for optimizing patient outcomes in similar complex cases.
Abstract:
Intravascular leiomyomatosis is a rare, histologically benign disease, and can spread through the venous system to the right cavities of the heart. We report the case of a 39-year-old woman who presented with intravenous leiomyomatosis with extension to the right ventricle, causing heart failure. She underwent surgery successfully, undergoing a total resection of this tumor through the infrarenal cava and the hysterectomy in one surgical stage. Surgical technique considerations are discussed and the literature is reviewed.