Successful one-stage resection of intravenous leiomyomatosis of the uterus with extension into the heart

Stolf, Noedir Antônio Groppo; Santos, Gilmar Geraldo dos; Haddad, Vítor; Simões, Rosa Maria da Costa; Jr, Silas F Avelar; Ferreira, Firmino Haag; Sobral, Marcelo Luiz Peixoto

doi:10.1016/s0967-2109(99)00003-4

Cited by 21 publications

(12 citation statements)

References 32 publications

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“…11,[21][22][23] As a simple and safe approach to removing the iliocaval portion of the IVL, iliac venotomy could be used in 1-and 2-stage operations. 24 Surgical mortality is low, and the follow-up study in our series suggests that the recurrence rate is also low. The only 2 recurrences in our series were related to the incomplete excision of the intracardiac leiomyoma in type C ICL or a lack of the ligation of the internal iliac vein or its tributary in type D ICL.…”

Section: Discussion the General Image Of Iclsupporting

confidence: 49%

Surgical treatment of intracardiac leiomyomatosis

Gan

Zhang

Zhou

et al. 2011

The Journal of Thoracic and Cardiovascular Surgery

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Section: Discussion the General Image Of Iclsupporting

confidence: 49%

Surgical treatment of intracardiac leiomyomatosis

Gan

Zhang

Zhou

et al. 2011

The Journal of Thoracic and Cardiovascular Surgery

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“…Symptomatic patients presented with a various symptoms, the most common being dyspnoea, syncope, oedema of the lower extremities and palpitations, followed by fatigue, ascites, jugular vein distension, chest pain, abdominal pain and hepatomegaly. In a few cases, other manifestations, such as dizziness [19,33,[36][37][38][39][40], cyanosis [31,[41][42][43], cough [42,44], vomiting [24,43,45], chest tightness [27,33,46], menstrual disorder [32,[46][47][48], orthopnoea [39,49,50], lethargy [51][52][53], headache [11,54,55], sweating [24,43,55], postmenopausal bleeding [56][57][58], weight loss [56,59], shock [42,60], nausea [43,61], hypotension [24,42], skin petechiae [31,…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Intracardiac leiomyomatosis: a comprehensive analysis of 194 cases

Chen

Chu

et al. 2013

Interactive CardioVascular and Thoracic Surgery

116

167

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Intracardiac leiomyomatosis is rare but has been increasingly reported in recent years. Owing to its rarity, intracardiac leiomyomatosis has been reported only as isolated case reports and case series. This disorder is thought to be underestimated and easily overlooked in the clinic, while it is dangerous owing to the risk of sudden death caused by total outflow tract obstruction. We performed an electronic literature search for intracardiac leiomyomatosis and identified 194 cases that were reported in English from 1974 (the first reported case) to September 2012. Our aim is to provide a detailed and comprehensive review of the clinical presentation, diagnosis, histopathological characterization, treatment and prognosis of this disorder. According to our analysis, intracardiac leiomyomatosis is most common in the fifth decade, and the mean age of detection is ~50 years. Most patients had undergone previous hysterectomy/myomectomy or had a coexisting uterine leiomyoma when admitted. The most common clinical presentations were dyspnoea, syncope, oedema of the lower extremities and palpitation. Transoesophageal echocardiography, computed tomography and magnetic resonance imaging are helpful in the preoperative diagnosis and to guide the surgical management. Complete removal guarantees an excellent outcome, with no recurrence or postoperative death, while incomplete removal leads to recurrence in one-third of patients. Anti-oestrogen therapy is not imperative after incomplete removal owing to its inability to prevent recurrence.

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“…Pathologic reports indicate that extrauterine involvement occurs in 30%-80% of cases, and cardiac involvement is seen in 10%-30% (1,6,8,9). When the tumor propagates into the heart, it may extend to involve the right atrium (45.6% of cases), right ventricle (45.6%), or pulmonary vasculature (8.8%) (10).…”

Section: Discussionmentioning

confidence: 99%

AIRP Best Cases in Radiologic-Pathologic Correlation: Intravenous Leiomyomatosis

Bender

Mitsumori²,

Lloyd³

et al. 2011

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A 55-year-old woman with a history of hypertension and multiple cesarean sections presented for her annual physical examination. The patient had undergone menopause 4 years earlier and had a 28-year history of oral contraceptive use. She reported a recent diagnosis of asthma. Routine electrocardiography showed slight changes from the previous year. Stress electrocardiography was subsequently performed, and before being aborted due to the patient's shortness of breath, demonstrated ST depression in the inferior and anterolateral leads. Echocardiography revealed a mass within the right atrium. At physical examination, the patient had fullness in the right lower quadrant and mild lower extremity edema. Imaging FindingsCardiac magnetic resonance (MR) imaging was performed at the community hospital where the patient first presented. Images from this study demonstrated a 5 × 4-cm mobile mass within the right atrium with a stalk extending down into the inferior vena cava (IVC). The mass prolapsed across the tricuspid valve and into the right ventricle during diastole with associated tricuspid regurgitation (Fig 1). The right ventricular ejection fraction was slightly low at 37% (lower limit of normal = 40%), but the left ventricular ejection fraction was normal at 69% (lower limit of normal = 50%). Findings of mild right atrial and right ventricular enlargement and diastolic interventricular septal flattening suggested increased right ventricular pressure.

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Successful one-stage resection of intravenous leiomyomatosis of the uterus with extension into the heart

Cited by 21 publications

References 32 publications

Surgical treatment of intracardiac leiomyomatosis

Surgical treatment of intracardiac leiomyomatosis

Intracardiac leiomyomatosis: a comprehensive analysis of 194 cases

AIRP Best Cases in Radiologic-Pathologic Correlation: Intravenous Leiomyomatosis

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