Research & Innovation in Anesthesia

Register      Login

VOLUME 7 , ISSUE 1 ( January-June, 2022 ) > List of Articles

CASE REPORT

Anesthetic Management of a Rare Case of Uterine Leiomyoma with Intravenous and Intracardiac Leiomyomatosis

Abhishek P Singh, Shilpa S Bhojraj, Nitin M Bhorkar, Anam Penkar

Keywords : Anesthesia, Cardiopulmonary bypass, Deep hypothermic circulatory arrest, Intracardiac leiomyomatosis, Intravenous leiomyomatosis

Citation Information : Singh AP, Bhojraj SS, Bhorkar NM, Penkar A. Anesthetic Management of a Rare Case of Uterine Leiomyoma with Intravenous and Intracardiac Leiomyomatosis. Res Inno Anesth 2022; 7 (1):29-31.

DOI: 10.5005/jp-journals-10049-2008

License: CC BY-NC 4.0

Published Online: 30-03-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Background: Intravenous leiomyomatosis (IVL) is an uncommon entity characterized by the growth of benign, smooth muscle tumors within the venous system. Intracardiac extension of this tumor is rare, and very few cases have been reported in the literature. Case description: We describe a case of IVL with intracardiac extension in a 55-year-old woman, who presented with severe dyspnea, ascites, and lower limb edema. Two-dimensional transthoracic echocardiography and computed tomography showed that the pelvic mass infiltrated the inferior vena cava via the iliac vessels and was extending to the right ventricle and pulmonary artery. The patient underwent a one-stage multidisciplinary thoracoabdominal operation with cardiopulmonary-bypass and deep hypothermic circulatory arrest. Conclusion: Due to the rarity of the present pathology, awareness is widely scarce and diagnosis is often deferred. A correct timely diagnosis, reasonable perioperative plan, and radical excision guarantees favorable outcomes.


HTML PDF Share
  1. Vaideeswar P, Kulkarni DV, Karunamurthy A, et al. Intracardiac leiomyomatosis: report of two cases. Indian J Pathol Microbiol 2011;54(1):158–160. DOI: 10.4103/0377-4929.77388
  2. Kocica MJ, Vranes MR, Kostic D, et al. Intravenous leiomyomatosis with extension to the heart: rare or underestimated? J Thorac Cardiovasc Surg 2005;130(6):1724–1726. DOI: 10.1016/j.jtcvs.2005.08.021
  3. Lee S, Kim DK, Narm KS, et al. Pulmonary artery embolization of intravenous leiomyomatosis extending into the right atrium. Korean J Thorac Cardiovasc Surg 2011;44(3):243–246. DOI: 10.5090/kjtcs.2011.44.3.243
  4. Clay TD, Dimitriou J, McNally OM, et al. Intravenous leiomyomatosis with intracardiac extension -a review of diagnosis and management with an illustrative case. Surg Oncol 2013;22(3): e44–e52. DOI: 10.1016/j.suronc.2013.03.004
  5. Li B, Chen X, Chu YD, et al. Review Intracardiac leiomyomatosis: a comprehensive analysis of 194 cases. Interact Cardiovasc Thorac Surg 2013;17(1):132–138. DOI: 10.1093/icvts/ivt117
  6. Mandelbaum I, Pauletto FJ, Nasser WK. Resection of a leiomyoma of the inferior vena cava that produced tricuspid valvular obstruction. J Thorac Cardiovasc Surg 1974;67(4):561-567. DOI: 10.1016/S0022-5223(19)40487-X
  7. Ariza A, Cerra C, Hahn IS, et al. Intravascular leiomyomatosis of the uterus. A case report. Conn Med 1982;46(12):700–703.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.