Intravascular leiomyomatosis with intracardiac extension: A case report

Chen, Yali; Zheng, Ai; Han, Ling

doi:10.1016/j.asjsur.2021.09.002

Cited by 4 publications

(10 citation statements)

References 4 publications

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“…Intravascular leiomyomatosis (IVL) is an extremely rare mesodermal cell tumor [ 1 ]. Since the first description of IVL in 1896, fewer than 300 cases have been reported in the English literature [ 1 , 2 ]. It primarily affects women of reproductive age (30%) and has extrauterine involvement in about 30% of cases [ 1 , 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Intravenous leiomyomatosis is a rare benign uterine tumor that can proliferate throughout the venous system without invading it [ 1 ]. Its treatment represents a surgical challenge since it requires the coordination of cardiothoracic, vascular, and gynecological surgeons [ 1 , 2 ]. Complete excision is ideal since incomplete resection can lead to recurrence and lifelong morbidity [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Its treatment represents a surgical challenge since it requires the coordination of cardiothoracic, vascular, and gynecological surgeons [ 1 , 2 ]. Complete excision is ideal since incomplete resection can lead to recurrence and lifelong morbidity [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Intravascular leiomyomatosis with cardiac extension, a case report

Garcés Garcés,

Terán Camacho,

Dávalos Dávalos

et al. 2023

J Cardiothorac Surg

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Background Intravascular leiomyomatosis (IVL) is a histologically benign smooth muscle tumor arising from the uterus that can spread through the pelvic veins and, on rare occasions, extend as far as the heart via the inferior vena cava. Despite its benign characteristics, it can behave like a malignant tumor leading to significant morbidity and even mortality if left untreated. Case presentation The patient is a 42-year-old woman with a past medical history of uterine leiomyomas. She presented with heavy bleeding and frequent spotting; therefore, she went to her gynecologist. After further evaluation, a mass within the uterus that expanded into the pelvic veins, inferior vena cava, and right atrium was discovered. After the complete removal of the mass, the patient underwent full recovery. IVL with cardiac extension was the final diagnosis. Conclusion Although IVL is rare, it must be considered in women who underwent previous hysterectomies or myomectomies and present with symptoms of right heart failure. The ideal therapy will need the aid of a multidisciplinary team and will depend on the patient’s symptoms, previous operative history, the tumor’s extension, and resectability.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intravascular leiomyomatosis with cardiac extension, a case report

Garcés Garcés,

Terán Camacho,

Dávalos Dávalos

et al. 2023

J Cardiothorac Surg

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“…Surgery is the most common and effective treatment, but it depends on whether the tumor can be excised entirely. (2,4) Since 1982, two surgical procedures have been performed to treat intravascular leiomyomatosis with heart extension. ( 9) The rst requires completely removing the intracardiac and intracaval mass through a one-stage surgical approach, and the other requires a two-stage abdominal stage and a thoracic stage; the approach will depend on the preoperative status of the patient and the extension of the tumor.…”

Section: Discussionmentioning

confidence: 99%

“…(1, 2) Complete removal is ideal, as incomplete resection can lead to recurrence and life-long morbidity. (2,3) We present the case of a 42-year-old woman with a mass within the uterus that expanded into the pelvic veins, inferior vena cava, and right atrium was discovered. After the complete removal of the mass, the patient underwent full recovery.…”

Section: Introductionmentioning

confidence: 99%

Intravascular leiomyomatosis with cardiac extension a “vessel within a vessel”

Garcés

Camacho

Dávalos

et al. 2022

Preprint

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Background Intravascular leiomyomatosis (IVL) is a histologically benign smooth muscle tumor arising from the uterus that can spread through the pelvic veins and can extend as far as the heart via the inferior vena cava. IVL is an extremely rare phenomenon, especially when the heart is involved. However, despite its benign characteristics, it can behave like a malignant tumor leading to significant morbidity and even mortality if left untreated. Case presentation The patient is a 42-year-old woman with a past medical history of uterine leiomyomas. Recently she developed heavy bleeding and frequent spotting; therefore consulted with her gynecologist. After further evaluation, a mass within the uterus that expanded into the pelvic veins, inferior vena cava, and right atrium was discovered. After the complete removal of the mass, the patient underwent full recovery. IVL with cardiac extension was the final diagnosis. Conclusion Although IVL is rare, it must be considered in women who underwent previous hysterectomies or myomectomies and presented with pelvic masses or symptoms of right heart failure. The ideal treatment will require the joint efforts of a complete multidisciplinary team, the patient's symptoms, previous operative history, the tumor's extension, and resectability.

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