Wu Yi-Hsiao, Lee Yung-Tsai, Lee Chuin-I, Tzeng Yun-Hsuan, Wei Jeng
Department of Cardiovascular Surgery, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung City.
Heart Center, Cheng-Hsin General Hospital, Taipei.
Medicine (Baltimore). 2019 Jan;98(3):e14118. doi: 10.1097/MD.0000000000014118.
Pulmonary embolism is a potentially devastating medical condition. Although deep-vein thrombosis is the most common etiology, a nonthrombotic pulmonary embolism is not uncommon.
A 45-year-old woman was admitted to our hospital for progressive effort dyspnea for 3 weeks.
Echocardiography revealed a mobile mass extending from the right atrium to the bilateral proximal pulmonary artery. As the mass was no response to thrombotic therapy, intravenous leiomyomatosis was suspected. Computed tomography (CT) revealed a hypo-attenuated tumor extending from the ovarian vein to the pulmonary artery.
A 1-stage operation for the surgical removal of the tumor, right salpingo-oophorectomy and subtotal hysterectomy were performed. Surgical specimen was identified as uterine leiomyomatosis without malignant transformation.
The patient was followed- up for 2 years and subsequent CT did not reveal any notable lesions.
Nonthrombotic pulmonary embolism is a potentially life-threatening complication. This case indicated intravenous leiomyomatosis should be considered in the differential diagnosis for certain cases. Complete surgical excision was the only curative treatment.
肺栓塞是一种潜在的严重疾病。虽然深静脉血栓形成是最常见的病因，但非血栓性肺栓塞也并不罕见。
一名45岁女性因进行性劳力性呼吸困难3周入院。
超声心动图显示一个可移动的肿块从右心房延伸至双侧近端肺动脉。由于该肿块对血栓治疗无反应，怀疑为静脉内平滑肌瘤病。计算机断层扫描（CT）显示一个低密度肿瘤从卵巢静脉延伸至肺动脉。
进行了一期手术，切除肿瘤、右侧输卵管卵巢切除术和子宫次全切除术。手术标本被确定为未发生恶变的子宫平滑肌瘤病。
对患者进行了2年随访，后续CT未发现任何明显病变。
非血栓性肺栓塞是一种潜在的危及生命的并发症。该病例表明，在某些病例的鉴别诊断中应考虑静脉内平滑肌瘤病。完整的手术切除是唯一的治愈性治疗方法。
