Peña Aileen, Tamaña Marvin
Philippine Heart Center, East Avenue, Quezon City 0850, Philippines.
Radiol Case Rep. 2018 Feb 21;13(2):427-430. doi: 10.1016/j.radcr.2018.01.022. eCollection 2018 Apr.
Leiomyoma of uterine origin is a common histologically benign neoplasm in women; however, growth intravenously with intracardiac extension is a rare phenomenon. This is a diagnostic challenge that can present with varied clinical manifestations and multiple differential diagnosis. This is a case of a 45-year-old female patient with chest heaviness and an intracardiac mass on 2-dimensional (2D) echocardiogram. Previous history of hysterectomy was likewise noted. Imaging workup, including 2D echocardiogram and contrast-enhanced chest and abdomen computed tomography scans, was performed which demonstrated a large, heterogeneous, elongated filling defect in the right atrium and right ventricle extending to the inferior vena cava, left renal vein, and left gonadal vein. The diagnosis was made after resection of the tumor in a single-stage operation. The histopathologic and immunoprofile of the resected tumor were consistent with leiomyoma. The use of multiple imaging modalities such as 2D echocardiogram and computed tomography are essential in the investigation of the intracaval masses with intracardiac extension. Although intravenous leiomyoma with intracardiac extension is a rare phenomenon, radiologists and clinicians alike should be mindful of this differential diagnosis.
子宫源性平滑肌瘤是女性常见的组织学良性肿瘤;然而,静脉内生长并向心腔内延伸是一种罕见现象。这是一个诊断难题,可能表现出多种临床表现且有多种鉴别诊断。这是一例45岁女性患者,二维(2D)超声心动图显示有胸部闷痛和心腔内肿块。既往子宫切除术病史也有记录。进行了包括2D超声心动图以及胸部和腹部增强计算机断层扫描在内的影像学检查,结果显示右心房和右心室内有一个大的、不均匀的、细长的充盈缺损,延伸至下腔静脉、左肾静脉和左性腺静脉。在一期手术切除肿瘤后做出了诊断。切除肿瘤的组织病理学和免疫表型与平滑肌瘤一致。使用多种成像方式,如2D超声心动图和计算机断层扫描,对于研究向心腔内延伸的腔静脉内肿块至关重要。尽管静脉内平滑肌瘤伴心腔内延伸是一种罕见现象,但放射科医生和临床医生都应留意这种鉴别诊断。