Butler Marcus William, Sanders Abraham
Division of Pulmonary and Critical Care Medicine, New York Presbyterian Hospital-Weill Cornell Medical College 520 East 70 Street, Starr 505, New York, NY 10021 USA.
Cases J. 2009 Jul 22;2:8159. doi: 10.4076/1757-1626-2-8159.
Intra cardiac tumours and tumour thrombi can present in a manner resembling a massive pulmonary embolism. Intravascular leiomyomatosis with intracardiac extension is one such rare tumour. Survival from obstructive shock in this condition has not been previously reported.
A case is presented of a female who presented with recurrent syncope, cyanosis and then circulatory shock. An intravascular and intracardiac mass was suspected. Due to refractory shock, she ultimately underwent single stage median sternotomy and exploratory laparotomy, with excision of an intravascular leiomyoma.
Intravascular leiomyoma with intracardiac extension should be suspected in the differential diagnosis of a female with a history of uterine fibroids or hysterectomy and presenting with right heart obstructive symptoms.
心脏内肿瘤和肿瘤血栓可表现出类似大面积肺栓塞的症状。伴有心脏内延伸的血管内平滑肌瘤就是这样一种罕见肿瘤。此前尚未有关于这种情况下梗阻性休克患者存活情况的报道。
报告一例女性患者,该患者出现反复晕厥、发绀,随后出现循环性休克。怀疑存在血管内及心脏内肿物。由于休克难以纠正,她最终接受了一期正中胸骨切开术和剖腹探查术,切除了一个血管内平滑肌瘤。
对于有子宫肌瘤病史或子宫切除术史且出现右心梗阻症状的女性,在鉴别诊断时应怀疑伴有心脏内延伸的血管内平滑肌瘤。