Echocardiographic Study of Intravenous Leiomyomatosis with Intracardiac Extension: Two Case Reports and Review of the Literature

Li, Rongjuan; Zhang, Chuanchen; Yang, Ya; Song, Li; Wang, Zheng; Luo, Xiang-hong; Su, Ruijuan

doi:10.1016/j.hlc.2012.11.018

Cited by 7 publications

(4 citation statements)

References 3 publications

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“…Echocardiogram revealing a freely a mobile mass, without attachment to the endocardium, and well-demarcated borders in the right heart chambers are consistent with IVL. 3 Moreover, TTE of the IVC may show a mobile, serpentine venous cast. These echocardiographic features of IVL are distinct from the fixed lesions more commonly observed in metastatic disease.…”

Section: Discussionmentioning

confidence: 99%

“…These echocardiographic features of IVL are distinct from the fixed lesions more commonly observed in metastatic disease. 3 Transthoracic echocardiogram alone, however, may lead to misdiagnosis of a primary cardiac mass and CT imaging is important for identifying the origin, size, and route of invasion. 10 The utility of CMR in the evaluation of cardiac masses is well established.…”

Section: Discussionmentioning

confidence: 99%

“…1 The diagnostic imaging features of these tumours remain poorly described. 2 , 3 Herein, we describe the features of IVL on echocardiogram, computed tomography (CT), and cardiac magnetic resonance (CMR) imaging from the case of a healthy female who initially presented for abdominal distention and was found to have a pelvic mass with intracaval and intracardiac involvement.…”

Section: Introductionmentioning

confidence: 99%

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Case report: intravenous leiomyomatosis with intracaval and intracardiac growth

Kikuchi

Goulbourne

Starbuck

et al. 2022

European Heart Journal - Case Reports

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Background Intravenous leiomyomatosis (IVL) is a rare, benign smooth muscle cell tumour that extends beyond the pelvis. These tumours grow within vascular channels and can progress to involve the heart and pulmonary vasculature. Case Summary A 44-year-old female initially presented to her primary care physician for subacute bloating. In the weeks leading up to her presentation, she was in good health. On admission, computed tomography (CT) imaging of the abdomen and pelvis was notable for a mixed solid and cystic mass arising from the fundal myometrium with invasion into the inferior vena cava (IVC). Transthoracic echocardiogram (TTE) was notable for mobile mass in the right atrium originating from the IVC. The mass was further evaluated by cardiac magnetic resonance imaging (CMR) before a multidisciplinary, single-staged thoracoabdominal resection was performed. The procedure was well tolerated, and the entire mass was successfully removed without complication. Subsequently, pathological analysis of the resected tumour revealed benign smooth muscle cells, confirming the diagnosis of IVL. Discussion IVL is a rare cause of right-sided cardiac tumours but should be considered in premenopausal females, even those with a prior history of hysterectomy. The clinical presentation of patients with IVL is varied and imaging including CMR, CT, and TTE to evaluate the tissue characteristics and source of the cardiac mass should be performed. Finally, while imaging revealing a freely mobile pelvic mass extending into the IVC and right heart chambers is strongly suggestive of IVL, definitive diagnosis requires pathological analysis of resected tissue.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Case report: intravenous leiomyomatosis with intracaval and intracardiac growth

Kikuchi

Goulbourne

Starbuck

et al. 2022

European Heart Journal - Case Reports

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“…6 IVL reportedly occurs in women aged 28 to 80 years 5 (median age, 45 years), and most are in the perimenopausal stage. Generally, patients with IVL have a history of uterine myomas 7 or hysterectomy. The cytogenetics and molecular biology of patients with IVL have rarely been described.…”

Section: Introductionmentioning

confidence: 99%

Intravenous leiomyomatosis: Case series and review of the literature

2020

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Background: We retrospectively reviewed the data of three patients with intravenous leiomyomatosis (IVL), one of whom had intracardiac leiomyomatosis, and analyzed their clinical symptoms, preoperative assessment findings, operative approaches, and recurrence. Case presentation: The present study describes three cases of IVL extending into the inferior vena cava, even as far as the right atrium and ventricle, and discusses the imaging findings and differential diagnosis of this tumor entity. The three patients, two of whom were diagnosed during the first operation and one of whom had a giant pelvic mass, were surgically treated with complete tumor resection, hysterectomy, and bilateral salpingo-oophorectomy. The pathological examination findings were suggestive of IVL. The duration of time from the first myomectomy or hysterectomy to IVL occurrence ranged from 2 to 18 months. No signs of recurrence were observed during follow-up. Computed tomography and magnetic resonance imaging played a vital role in the diagnostic process and presurgical assessment. Conclusion: In clinical practice, IVL should be considered before surgery for a broad ligament myoma or giant pelvic mass. Surgery should always aim for complete tumor excision and include hysterectomy and bilateral salpingo-oophorectomy. Vascular reconstruction computed tomography is a good choice for diagnosis and follow-up.

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