Intracardiac atypical leiomyoma involving all four cardiac chambers and the aorta

Area of Science:

• Gynecologic Oncology
• Cardiovascular Surgery
• Pathology

Background:

• Intravenous leiomyomatosis is a rare condition where benign smooth muscle tumors spread through vascular channels.
• Cardiac involvement is a rare but serious complication, typically affecting the right heart chambers.
• Intracardiac leiomyomas can cause significant symptoms or be found incidentally.

Purpose of the Study:

• To report a unique case of intracardiac leiomyomatosis involving all four cardiac chambers.
• To highlight the extended intracardiac and aortic root involvement of intravenous leiomyomatosis.
• To discuss the diagnostic and surgical implications of this rare presentation.

Main Methods:

• Case report of a 40-year-old female patient.
• Diagnostic workup included echocardiography.
• Surgical intervention for tumor removal.

Main Results:

• An asymptomatic 40-year-old woman presented with an incidental cardiac murmur.
• Echocardiography revealed an echodensity within all cardiac chambers.
• Cardiac surgery identified an intracardiac leiomyoma originating from the inferior vena cava, involving all four chambers and the aortic root.

Conclusions:

• Intracardiac leiomyomatosis can present atypically, extending beyond the right heart chambers.
• Comprehensive cardiac imaging and surgical exploration are crucial for diagnosis and management.
• This case underscores the importance of considering rare gynecologic complications in cardiovascular presentations.