Rationale:Pulmonary embolism is a potentially devastating medical condition. Although deep-vein thrombosis is the most common etiology, a nonthrombotic pulmonary embolism is not uncommon.Patient concerns:A 45-year-old woman was admitted to our hospital for progressive effort dyspnea for 3 weeks.Diagnosis:Echocardiography revealed a mobile mass extending from the right atrium to the bilateral proximal pulmonary artery. As the mass was no response to thrombotic therapy, intravenous leiomyomatosis was suspected. Computed tomography (CT) revealed a hypo-attenuated tumor extending from the ovarian vein to the pulmonary artery.Interventions:A 1-stage operation for the surgical removal of the tumor, right salpingo-oophorectomy and subtotal hysterectomy were performed. Surgical specimen was identified as uterine leiomyomatosis without malignant transformation.Outcomes:The patient was followed- up for 2 years and subsequent CT did not reveal any notable lesions.Lessons:Nonthrombotic pulmonary embolism is a potentially life-threatening complication. This case indicated intravenous leiomyomatosis should be considered in the differential diagnosis for certain cases. Complete surgical excision was the only curative treatment.
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