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Intravenous leiomyomatosis with involvement of the right heart

  • Case Report
  • Published:
Hellenic Journal of Surgery

Abstract

Background

Intravenous leiomyomatosis with right cardiac extension is a rare entity that poses a challenge for the surgeon. Herein, we present a successful, multidisciplinary management of such a case.

Case report

A 43-year-old female presented with recurrent lower extremity oedema and pain, symptoms which were more pronounced on the right side. Although radiological exams did not reveal lower extremity deep venous thrombosis, because of the persistent nature of the symptoms an MRI was performed which revealed uterine wall thickening and inferior vena cava thrombus, extending all the way into the right heart. Given the suspicion of malignancy and the patient’s young age and symptoms, a thoracoabdominal surgical approach was decided, and the patient was placed on a cardiopulmonary bypass. The intraluminal thrombus from the IVC and the right heart was removed, and a hysterectomy with bilateral salpingoophorectomy was performed. Pathological examination revealed intravenous leiomyomatosis. The patient had an uneventful postoperative course and was discharged on the twelfth postoperative day. Eighteen months later, she continues to be well.

Conclusions

Successful surgical management of intravenous leiomyomatosis, even when the right heart is involved, is possible when a multidisciplinary approach is undertaken.

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Authors and Affiliations

  1. Department of Surgery, Aristoteleion University of Thessaloniki, Papageorgiou G.H., Thessaloniki, Greece

    G. Tsoulfas, G. Georgantis, I. Lazaridis, N. Degermetzoglou, N. Saratzis, D. Kiskinis & G. N. Marakis

  2. Department of Cardiothoracic Surgery, Papageorgiou G.H., Thessaloniki, Greece

    P. Saripoulos

  3. Department of Gynecology and Obstetrics, Aristoteleion University of Thessaloniki, Papageorgiou G.H., Thessaloniki, Greece

    A. Papanikolaou

Authors
  1. G. Tsoulfas
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  2. G. Georgantis
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  3. I. Lazaridis
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  4. N. Degermetzoglou
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  5. N. Saratzis
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  6. P. Saripoulos
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  7. A. Papanikolaou
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  8. D. Kiskinis
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  9. G. N. Marakis
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Corresponding author

Correspondence to G. Tsoulfas.

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Tsoulfas, G., Georgantis, G., Lazaridis, I. et al. Intravenous leiomyomatosis with involvement of the right heart. Hellenic J Surg 85, 202–206 (2013). https://doi.org/10.1007/s13126-013-0038-0

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  • DOI: https://doi.org/10.1007/s13126-013-0038-0

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