Intravenous leiomyomatosis: A rare cause of intracardiac mass

Cruz, Inês; João, Isabel; Stuart, Bruno; Ialá, Mário; Bento, Luísa; Cotrim, Carlos; Nobre, Ângelo; Pereira, Hélder

doi:10.1016/j.repce.2014.04.006

Cited by 3 publications

(7 citation statements)

References 14 publications

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“…Thus far, no consensus has been reached regarding the cause of IVL, but there are 2 principal theories that are widely accepted. [1,9] The first states that leiomyomatous cells originating from the uterine myometrium invade the intima of the myometrial sinuses. The second holds that the tumor consists of proliferating smooth muscle cells and arises directly from the venous wall of the uterine or pelvic veins.…”

Section: Discussionmentioning

confidence: 99%

“…A diagnosis of IVL should be considered when a mass is discovered extending from the IVC to the right atrium on ultrasonography in a middle-aged woman, especially a woman with a history of hysterectomy or uterine hysteromyoma. [1] Ultrasonography, combined with contrast-enhanced ultrasonography, is a useful tool for the diagnosis of IVL, as it can provide information on the blood flow within the lesion, which is valuable during the differential diagnosis. Given the tumor's tendency to relapse, long-term postoperative follow-up is critically important.…”

Section: Discussionmentioning

confidence: 99%

“…Although IVL is histologically benign, it has the potential to grow along the veins and spread beyond the pelvic region and into the central veins and heart. [1] It can, therefore, cause severe complications, such as right ventricular outflow tract obstruction, pulmonary embolism, and sudden death.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound appearance of intravenous leiomyomatosis

Wang

et al. 2019

Medicine

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Rationale:Intravenous leiomyomatosis (IVL) is a rare benign smooth muscle tumor that can develop from the pelvic or uterine veins and spread into the central veins and heart. Here, we report a case of recurrent IVL in a 48-year-old woman. To the best of our knowledge, this is the first case report of IVL that describes the characteristic ultrasound features of the tumor, including the rainbow sign.Patient concerns:A 48-year-old woman developed a solid-cystic lesion in the inferior vena cava (IVC) 3 years after undergoing a right heart tumor resection and 5 years after undergoing hysterectomy.Diagnoses:Physical examination was unremarkable. However, ultrasonography showed a solid-cystic lesion in the IVC, and a diagnosis of IVL was made.Interventions:The patient underwent complete surgical removal of the tumor by a multidisciplinary team. The tumor was resected successfully.Outcomes:Pathological examination confirmed that the IVC tumor thrombus was consistent with IVL. During follow-up, there were no signs of local or distant recurrence.Lessons:The preoperative diagnosis of IVL is difficult, and the tumor is usually misdiagnosed as a thrombus or right atrial myxoma. A thorough understanding of the characteristic imaging features of IVL is essential for an accurate preoperative diagnosis. The lesion in our patient showed multiple tracts, a honeycomb appearance, and vividly colorful blood flow that resembled a rainbow, which we termed the rainbow sign.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Ultrasound appearance of intravenous leiomyomatosis

Wang

et al. 2019

Medicine

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“…However, accurate pre-operative diagnosis of IVL is usually still difficult, as it cannot be obtained until surgical resection and histological examination have been done. 6 IVL should be distinguished from malignant tumors, particularly leiomyosarcoma. However, it may be challenging to distinguish intravascular leiomyoma from leiomyosarcoma, because no symptoms, signs, or imaging can reliably differentiate between the two diagnoses.…”

Section: Discussionmentioning

confidence: 99%

One Stage Radical Removal of Intravenous Leiomyomatosis Extending to the Right Atrium via the Bilateral Gonadal Veins

Gui

et al. 2015

EJVES Short Reports

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Background: Intravenous leiomyomatosis is a benign and rare smooth muscle cell tumor. Extension to the right heart is exceptional. Among the reported cases, the tumor is usually known to enter through the lumen of the iliac vein and grows into the inferior vena cava; involvement of bilateral gonadal veins is rarely reported. Complete tumor resection is the key to therapy. Case presentation: A 25 year old female Chinese patient suffering from abdominal distention for 1 month, who was diagnosed with intravenous leiomyomatosis extending to the heart, from pre-operative imaging studies, is presented. A one stage procedure with complete excision of the tumor was performed. Histopathological findings confirmed the diagnosis of intravenous leiomyomatosis. The patient's post-operative recovery was uneventful, without recurrence and re-stenosis at 1 year follow up. Conclusion: Intravenous leiomyomatosis may grow within veins along various routes. This case demonstrated intravenous leiomyomatosis with tumor extension through bilateral gonadal veins extending to the heart. It is believed that one stage radical resection can be a practical and effective alternative for the patients in good clinical condition. Long-term follow up is recommended because of the possibility of recurrence and metastases.

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“…Although intravascular leiomyomata are histologically benign, they may be found beyond the pelvic region. Therefore they have the potential to cause severe complications, such as obstruction of the heart out low tract or vena cava, pulmonary embolism, even sudden death [3]. There are no speci ic symptoms of intravascular leiomyoma.…”

Section: Introductionmentioning

confidence: 99%

Intravascular leiomyoma misdiagnosed as deep vein thrombosis: A case report

Zhang¹,

Feng²,

Liu³

et al. 2021

J Radiol Oncol

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Background: Leiomyoma itself is not a rare disease, but it is rarely found intravascularly. Case presentation: A 54-year old female sought medical help after noticing her leg being swelling. A diagnosis of deep vein thrombosis (DVT) was made and antithrombotic treatment was given after her initial imaging exam. Several days later, a contrast CT and sequential pathology revealed the real diagnosis was intravascular leiomyoma. The patient was discharged after a successful surgery. Conclusion: Intravascular leiomyoma should not be confused with DVT.

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Intravenous leiomyomatosis: A rare cause of intracardiac mass

Cited by 3 publications

References 14 publications

Ultrasound appearance of intravenous leiomyomatosis

Ultrasound appearance of intravenous leiomyomatosis

One Stage Radical Removal of Intravenous Leiomyomatosis Extending to the Right Atrium via the Bilateral Gonadal Veins

Intravascular leiomyoma misdiagnosed as deep vein thrombosis: A case report

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