Intravenous leiomyomatosis with right heart involvement—A report of 4 cases and literature review

Abstract

Intravenous leiomyomatosis (IVL) is a rare benign neoplasm which originates from the smooth muscle cells and is usually confined to the pelvic venous system. Rarely, intracaval and intracardiac extension has been described. Death can occur as a result of intracardiac involvement. We reported 4 cases of IVL with right heart involvement (intracardiac leiomyomatosis, ICL). Three of them suffered recurrent sudden syncope, and the other one was totally asymptomatic. All of them were successfully treated through one-stage operation under extracorporeal circulation.

Keywords

intravenous leiomyomatosis / intracardiac leiomyomatosis / cardiac tumor / surgical management

References

[1] CastelliP., CaronnoR., PiffarettiG., et al.. Intravenous uterine leiomyomatosis with right heart extension: Successful two-stage surgical removal. Ann Vascu Surg, 2006, 20(3): 405-407

[2] GaudinoM., SpatuzzaP., SniderF., et al.. Surgical management of a uterine leiomyoma extending through the inferiorvena cava into the right heart. Heart Vessels, 2002, 17(2): 80-82

[3] MulvanyN.J., SlavinJ.L., OstorA.G., et al.. Intravenous leiomyomatosis of the uterus: a clinical-pathologic study of 22 cases. Int J Gynecol Pathol, 1994, 13(1): 1-9

[4] LamP.M., LoK.W., YuM.M., et al.. Intravenous leiomyomatosis with atypical histologic features: a case report. Int J Gynecol Cancer, 2003, 13(1): 83-87

[5] MaS.Q., BaiC.M., YuX.H., et al.. Clinical pathological analysis of uterine intravenous leiomyomatosis. Chin J Gynaecol Obstet (Chinese), 2005, 40(1): 34-37

[6] LoK.W., LauT.K.. Intracardiac leiomyomatosis: case report and literature review. Arch Gynecol Obstet, 2001, 264(4): 209-210

[7] NamM.S., JeonM.J., KimY.T., et al.. Pelvic leiomyomatosis with intracaval and intracardiac extension: a case report and review of the literature. Gynecol Oncol, 2003, 89(1): 175-180

[8] WongY.Y., ChuW.C., LamW.W.. Intravenous leiomyomatosis: computed tomography diagnosis. Hong Kong Med J, 2006, 12(3): 239-240

[9] RoqesF., SanchezB., BucherB., et al.. Role of pre-operative assessment in the surgical management of leiomyoma extended to the right heart chambers: a compendium of information from isolated reports. Eur J Cardiothorac Surg, 2001, 19(4): 522-524

[10] LamP.M., LoK.W., YuM.Y., et al.. Intravenous leiomyomatosis: two cases with different routes of tumor extension. J Vasc Surg, 2004, 39(2): 465-469

[11] BresciaR.J., TazelaarH.D., HobbsJ., et al.. Intravascular lipoleiomyomatosis: a report of two cases. Hum Pathol, 1989, 20(3): 252-256

[12] KokawaK., YamotoM., YataC., et al.. Postmenopausal intravenous leiomyomatosis with high level of estradiol and estrogen receptor. Obstet Gynecol, 2002, 100(5pt2): 1124-1126