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Successful Surgical Treatment of an Aggressive Pelvic Angiomyxoma With Intracardiac Extension
Annastiina Husso1, Jukka Savola1, Jarmo Gunn2
1Department of Cardiothoracic Surgery, Heart Center, Turku University Hospital, Turku, Finland.
Insights
A rare pelvic angiomyxoma invaded the heart, posing significant surgical risks. Successful complex resection on cardiopulmonary bypass allowed for patient recovery and subsequent hormonal therapy.
Area of Science:
- Cardiovascular Surgery
- Gynecologic Oncology
- Vascular Surgery
Background:
- Pelvic angiomyxoma is a rare benign tumor with a propensity for local invasion.
- Intracardiac extension of pelvic tumors is exceptionally uncommon and presents significant management challenges.
- The initial presentation mimicked caval and intracardiac thrombus, delaying definitive diagnosis.
Observation:
- A case is presented of a patient with a pelvic angiomyxoma extending into the right atrium and right ventricle.
- The tumor involved the suprarenal vena cava and left iliac vein.
- Surgical intervention was deemed high-risk due to the extensive tumor infiltration.
Findings:
- The tumor was successfully resected from the right atrium, suprarenal vena cava, and left iliac vein.
- The procedure required cardiopulmonary bypass and deep hypothermic circulatory arrest.
- Affected gynecological organs were removed concurrently.
Implications:
- This case highlights the importance of thorough investigation for rare pelvic tumors with unusual extensions.
- Complex surgical techniques, including cardiopulmonary bypass, can be safely employed for extensive tumor resections.
- Multidisciplinary management is crucial for optimizing outcomes in rare oncologic and vascular cases.
Abstract:
We present a case of an intravenous tumor with extension into the right atrium and right ventricle of the heart. Pelvic angiomyxoma is a rare benign tumor, which in this case carried a significant operative risk due to its extension. The patient initially presented with suspected caval and intracardiac thrombus, but unsuccessful treatment led to further investigations. The tumor was extensively dissected from the right atrium, suprarenal vena cava, and left iliac vein on cardiopulmonary bypass and deep hypothermic circulatory arrest. Affected gynecological organs were removed. The patient recovered uneventfully and received hormonal therapy postoperatively.
