RESUMEN
Objective To improve the diagnosis and therapy level of the uterine intravenous eiomyomatosis, we reported one case involving the right heart and reviewed the relative literatures.Methods and results The patient is 38 years old, she was admitted to hospital with fever, abdominal pain and chest tightness for one week in July 2010. She had a total hysterectomy owing to hysteromyoma in 2003. In July 2010, because she wanted a baby with the method of surrogate pregnancy, so she was injected medicine to stimulate follicle growth in the USA. The medicine was Li ShenBao injection, the total of 12d daily 3 branch (dose not stated). Afterward she couldn't stand fever, abdominal distension and chest tightness, she returned to China for treatment. After she was hospitalized, for diagnosis she got many image examination done, such as B-scan, CT, MRI and PET/CT. Result All image examination found that a massive solid and cystic tumor in the abdominal and pelvic cavity, left kidney hydrocele, ascites, and tumor embolus in the right atrium, inferior caval vein, left renal vein, also bilateral iliac vein. The thoracic-abdominal surgery was carried out, massive tumor was removed, also the tumor embolus in the right atrium and inferior caval vein. The pathological diagnosis was uterine intravenous leiomyomatosis. Conclusion Uterine intravenous leiomyomatosis is a rare disease, involving to heart case is seldomness. In recent years, the case increasing could be related with the usage count of sex hormone in Assisted Reproductive Technology. The imaging examination can give a confident diagnosis, and the final diagnosis depend on pathology. For treatment, surgery is the first choice, and must be thorough to prevent recurrence.
RESUMEN
Intravenous leiomyomatosis (IVL) is rare and it is characterized by intravascular nodular masses of benign smooth muscle that may extend to variable site such as uterus, pelvic veins, inferior vena cava, right sided heart and eventually lung. We experienced an unusual case of IVL originating from the uterus and extending to the lung parenchyma and treated by combined surgery, so we report it with a brief review of the literatures.
Asunto(s)
Corazón , Leiomiomatosis , Pulmón , Músculo Liso , Útero , Venas , Vena Cava InferiorRESUMEN
A case of intravenous leiomyomatosis (IVL) invading the vena cava and extending to the right atrium, a rare benign smooth-muscle tumor, is described. Despite their histological benignity, these lesions have a tendency to metastasize and are closely related to the condition called "benign metastasizing leiomyoma" and "intracaval mass and cardiac extension". A 50-year old woman was admitted to the hospital with dyspnea beginning 6 months ago and previous history of hysterectomy due to uterine myoma. Echocardiography revealed severe tricuspid valve insufficiency and a mobile elongated mass which occupied the inferior vena cava and was extending into the right ventricular cavity. Pelvic ultrasonography and pelvic MRI identified suspicious metastasis to both ovaries and peritoneum. She underwent resection of the cardiac tumor, concomitant tricuspid annuloplasty with a closure of the foramen ovale and both salphyngo-oophorectomy with vaginal stump mass biopsy. All of them could be histologically identified as IVL.
Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Biopsia , Disnea , Ecocardiografía , Foramen Oval , Atrios Cardíacos , Neoplasias Cardíacas , Histerectomía , Leiomioma , Leiomiomatosis , Imagen por Resonancia Magnética , Metástasis de la Neoplasia , Ovario , Peritoneo , Insuficiencia de la Válvula Tricúspide , Ultrasonografía , Vena Cava InferiorRESUMEN
Intravenous leiomyomatosis (IVL) with intracaval mass, cardiac extension, and pulmonary metastasis is rare and it is characterized by nodular masses of smooth muscle proliferation that may extend to variable distances. We experienced a case of the intravenous leiomyomatosis originating from the uterus and extending to the ovarian veins, the iliac veins, the inferior vena cava, the right atrium and the lung. And it was diagnosed from the various preoperative studies and operated successfully through the single-stage approach. So we report it with a brief review of the literature.