Tumor in Transit: Intracardiac Leiomyomatosis

Area of Science:

• Cardiovascular Medicine
• Gynecologic Oncology
• Pathology

Background:

• Intravenous leiomyoma is a rare neoplastic proliferation originating from uterine leiomyomas with vascular invasion.
• Metastasis of intravenous leiomyoma to distant organs, particularly the heart, is exceptionally uncommon.
• Uterine fibroids (leiomyomas) are common, but their malignant transformation and vascular invasion are rare.

Observation:

• A case of intravenous leiomyoma metastasizing to the heart is presented.
• The cardiac metastasis resulted in severe tricuspid regurgitation.
• Right-sided cardiac masses necessitate thorough investigation to rule out rare etiologies.

Findings:

• Metastatic intravenous leiomyoma to the heart can cause significant hemodynamic compromise.
• Diagnosis requires a high index of suspicion, especially in women with a history of uterine fibroids or prior hysterectomy.
• Comprehensive imaging review is essential for accurate diagnosis and surgical planning.

Implications:

• Surgical intervention, often a staged approach involving cardiac and abdominal/pelvic surgery, is the primary treatment.
• Multidisciplinary team collaboration is vital for optimal patient management.
• Increased awareness of intravenous leiomyoma metastasis is needed to improve patient outcomes.