Details

Autor(en) / Beteiligte

• Tsoulfas, G.
• Georgantis, G.
• Lazaridis, I.
• Degermetzoglou, N.
• Saratzis, N.
• Saripoulos, P.
• Papanikolaou, A.
• Kiskinis, D.
• Marakis, G. N.

Titel

Intravenous leiomyomatosis with involvement of the right heart

Ist Teil von

• Hellenic journal of surgery, 2013-05, Vol.85 (3), p.202-206

Ort / Verlag

Vienna: Springer Vienna

Erscheinungsjahr

2013

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Background Intravenous leiomyomatosis with right cardiac extension is a rare entity that poses a challenge for the surgeon. Herein, we present a successful, multidisciplinary management of such a case. Case report A 43-year-old female presented with recurrent lower extremity oedema and pain, symptoms which were more pronounced on the right side. Although radiological exams did not reveal lower extremity deep venous thrombosis, because of the persistent nature of the symptoms an MRI was performed which revealed uterine wall thickening and inferior vena cava thrombus, extending all the way into the right heart. Given the suspicion of malignancy and the patient’s young age and symptoms, a thoracoabdominal surgical approach was decided, and the patient was placed on a cardiopulmonary bypass. The intraluminal thrombus from the IVC and the right heart was removed, and a hysterectomy with bilateral salpingoophorectomy was performed. Pathological examination revealed intravenous leiomyomatosis. The patient had an uneventful postoperative course and was discharged on the twelfth postoperative day. Eighteen months later, she continues to be well. Conclusions Successful surgical management of intravenous leiomyomatosis, even when the right heart is involved, is possible when a multidisciplinary approach is undertaken.