Gehr N R, Lund O, Alstrup P, Nielsen J S, Villadsen A B, Bartholdy N J
Department of Cardio-Thoracic Surgery, Aalborg Hospital, Denmark.
Scand Cardiovasc J. 1999;33(5):312-4. doi: 10.1080/14017439950141597.
A 28-year-old woman (gravida 2, para 2) was admitted 20 months after a hysterectomy because of fibromyoma. The hysterectomy specimen had shown intravenous leiomyomatosis. The patient presented with unspecific abdominal symptoms, serologic signs of hepatic and renal failure and clinical right-sided heart failure. Progression despite treatment with a gonadotropin-releasing hormone analogue promoted transferral to the present centre. Abdominal ultrasonography, phlebography and transoesophageal echocardiography showed a left pelvic mass and a seemingly free-floating tumour extending from the left main iliac vein via the inferior caval vein to the right ventricle. During a combined cardiac and distal caval approach using extracorporeal circulation, a 45 cm massive leiomyoma was removed successfully. Seven weeks later the left pelvic tumour was removed radically together with left oophorectomy. At control 12 months later the patient was well and without any remaining symptoms.
一名28岁女性（孕2产2）在因子宫肌瘤行子宫切除术后20个月入院。子宫切除标本显示为静脉内平滑肌瘤病。患者出现非特异性腹部症状、肝肾功能衰竭的血清学体征以及临床右侧心力衰竭。尽管使用促性腺激素释放激素类似物治疗仍有进展，促使其转至本中心。腹部超声、静脉造影和经食管超声心动图显示左盆腔肿块以及一个似乎自由漂浮的肿瘤，从左髂总静脉经下腔静脉延伸至右心室。在使用体外循环的心脏和下腔静脉远端联合入路手术中，成功切除了一个45厘米的巨大平滑肌瘤。七周后，连同左侧卵巢切除术一起彻底切除了左盆腔肿瘤。在12个月后的复查中，患者情况良好，无任何残留症状。
