Marrone Gianluca, Crinò Francesca, Morsolini Marco, Caruso Settimo, Miraglia Roberto
Diagnostic and Therapeutic Services, Radiology Unit, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy.
Department of Cardio-Thoracic Surgery, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy.
J Radiol Case Rep. 2019 Jul 31;13(7):1-13. doi: 10.3941/jrcr.v13i7.3607. eCollection 2019 Jul.
Uterine intravenous leiomyomatosis is an uncommon tumor, usually arising from the uterus, with nodular masses which extend intravascularly over variable distances and may reach the inferior vena cava, right atrium, and pulmonary arteries. Early diagnosis and surgical intervention are crucial as intracardiac leiomyomatosis not only causes cardiac symptoms but may result in pulmonary embolism and sudden death. Complete tumor resection is key in disease management, thus rendering cardiac-extending uterine intravenous leiomyomatosis one of the most challenging conditions for surgical treatment. The use of interventional radiology procedures can facilitate the surgical approach. We report the case of a massive pelvic recurrence of uterine leiomyomatosis with intracardiac extension and pulmonary embolism, analyzing management and surgical outcomes, highlighting the role of interventional radiology during the therapeutic pathway. Nonetheless, there are currently very few data available concerning the use of interventional radiology procedures in the therapeutic strategy of uterine intravenous leiomyomatosis with intracardiac extension.
子宫静脉内平滑肌瘤病是一种罕见的肿瘤，通常起源于子宫，有结节状肿块，可沿血管内延伸不同距离，甚至可到达下腔静脉、右心房和肺动脉。早期诊断和手术干预至关重要，因为心脏内平滑肌瘤病不仅会引起心脏症状，还可能导致肺栓塞和猝死。完整切除肿瘤是疾病管理的关键，因此心脏延伸型子宫静脉内平滑肌瘤病成为手术治疗最具挑战性的病症之一。介入放射学程序的应用有助于手术入路。我们报告一例子宫平滑肌瘤病伴心脏内延伸和肺栓塞的巨大盆腔复发病例，分析其管理和手术结果，突出介入放射学在治疗过程中的作用。尽管如此，目前关于介入放射学程序在心脏内延伸型子宫静脉内平滑肌瘤病治疗策略中的应用数据非常少。
