Imaging manifestations and treatment of uterine intravenous leiomyomatosis involving right heart / 第二军医大学学报

ABSTRACT

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.