Retroperitoneal leiomyoma that infiltrated into the right ventricle

Abstract

A 49-year-old woman with a history of uterine myomas, moderate hepatic insufficiency, and ascites, was found to have a cardiac murmur. Echocardiography showed dilation of the right atrium, moderate tricuspid insufficiency, and a right atrial mass that advanced on diastole to the apex of the right ventricle, suggesting a myxoma. At surgery, an intracardiac pediculated mass was seen emerging from the lumen of the inferior vena cava. The mass was carefully pulled as far as possible and transected. After histologic and immunohistochemistry studies, the tumor was reported as an extending intracardiac leiomyoma (Figure 1). Postoperative computed tomography revealed a giant retroperitoneal infiltrating mass, discarding the diagnosis of ascites (Figure 2). An abdominal approach is planned.