• 作者：Basilio Martí ; nez-Mora^a ; ^{basilio-martinez@hotmail.com} ; José ; Francisco Dí ; az-Ferná ; ndez^a ; Marí ; a Luisa Hidalgo-Ordó ; ñ ; ez^a ; Rafael Estefaní ; a-Morales^b
• 关键词：Leiomiomatosis ; Tumores card&iacute ; acos ; Aneurismas venosos ; Ecocardiograf&iacute ; a
• 刊名：Cardiocore
• 出版年：2011
• 期刊代码：pca84_1889898X
• 类别：med
• 出版时间：July-September 2011
• 卷：46
• 期：3
• 页码：e42-e44
• 文件大小：377 K

We present the case of a young woman who was admitted with a growth in her hypogastrium. A magnetic resonance imaging (MRI) found that her uterus had multiple highly vascularised tumours, which extended into the venous pelvic structures, inferior vena cava, right cardiac chambers and pulmonary arteries. The tumour was excised by traction from the iliac bifurcation in the inferior vena cava. The diagnosis was intravenous leiomyomatosis. Surgical intervention led to an unstable haemodynamic situation. Significant tricuspid regurgitation was found in a transoesophageal echocardiogram (TE). Some tumour remains were found in the tricuspid valve. A second surgical intervention was needed. A year later a number of venous pelvic aneurysms were discovered, possibly due to tumour recurrence, as well as some associated arteriovenous fistulae, a finding not described in the literature so far.

Intravenous leiomyomatosis is an uncommon benign, but invasive, mesenchymal tumour. Patients are normally asymptomatic for a long time, but they can suffer from heart failure, syncope or sudden death. The preferred treatment method is surgical excision. A transoesophageal echocardiogram is mandatory for surgical monitoring. Tumour follow up is based on imaging techniques such as CT scanning or MRI.