Intravenous leiomyomatosis with intracardiac extension: A case report with review of literature

Abstract

Intravenous leiomyomatosis (IVL) with intracardiac extension is a rare disease which has low diagnosis rate before operation. The article reported that a 46-year-old patient suffering from IVL with intracardiac extension was admitted in the Tianjin First Center Hospital on September 2, 2014. CT and PET-CT revealed bilateral ovarian cyst, pelvic nodules, bilateral pulmonary nodules, and a mass which existed from IVC to right ventricle (maximum area of 12 cm × 4 cm).The patient was diagnosed as IVL with intracardiac extension. Then the patient underwent myomatectomy and bilateral adnexectomy successfully under the cardiopulmonary bypass. The patient recovered well after operation and received regular follow-up. Episode of tumor has not recurred during the follow-up. IVL doesn’t have specific clinical manifestation, and its diagnosis mainly depends on the pathologic examination. Besides, imaging examination plays an important role in diagnosing it as a supplementary means. Operation is the main therapy. It is worth noting that complete resection is the key point. Total assessment for tumor extent is required before operation. Most of patients have good prognosis. However, it is possible to relapse, which lead to a necessary long-term follow-up.