Intracardiac Leiomyoma Leading to Liver Failure and Heart Failure Managed by VA-ECMO and Surgical Resection

Area of Science:

• Cardiology
• Oncology
• Pathology

Background:

• Intracardiac leiomyomatosis (ICL) is a rare condition involving intracardiac tumors, often linked to uterine leiomyomas.
• Early diagnosis of ICL is critical due to the potential for severe cardiac complications.

Observation:

• A 52-year-old woman presented with liver and heart failure attributed to a large right ventricular leiomyoma.
• The patient required venoarterial extracorporeal membrane oxygenation (ECMO) for stabilization.
• Surgical resection of the tumor was performed, with histological confirmation of a benign smooth muscle tumor.

Findings:

• ICL can present with multiorgan failure, posing diagnostic and management challenges.
• ECMO proved effective as a bridge therapy to surgical intervention.
• Benign smooth muscle tumors can manifest as intracardiac masses.

Implications:

• ICL must be considered in patients with right-sided intracardiac masses, particularly those with a history of hysterectomy.
• Aggressive management, including ECMO and timely surgery, is essential for improving outcomes in ICL patients.
• This case underscores the importance of a high index of suspicion for rare cardiac tumors in complex clinical presentations.