Department of Gynecologic Oncology, Ankara City Hospital, University of Health Sciences, Bilkent Avenue, No: 1, Ankara, Cankaya 06800, Turkey.
Department of Cardiovascular Surgery, Ankara City Hospital, University of Health Sciences, Ankara, Turkey.
J Gynecol Obstet Hum Reprod. 2022 Oct;51(8):102452. doi: 10.1016/j.jogoh.2022.102452. Epub 2022 Jul 31.
Intracardiac leiomyomatosis (ICLM) is a rare tumor that usually originates from the mesenchymal cells of the uterus. If left untreated, it may lead to cardiac symptoms and sudden death. The present case was a 45-year-old female patient who presented with occasional palpitations. The imaging methods revealed a heterogeneous mass likely to be leiomyoma with intense enhancement in the arterial phase in the uterus, extending from the ovarian and uterine veins to the heart through the inferior vena cava. The tumor council attributed these findings to intravenous leiomyomatosis with intracardiac extension. Accordingly, a multidisciplinary surgical team performed complete excision of the intracardiac leiomyomatosis in the patient presented herein using only the laparotomic approach. The gold standard in the treatment of ICLM is complete tumor excision. Excision of intracardiac tumors can be performed through controlled traction from the abdominal region.
心内平滑肌瘤病(ICLM)是一种罕见的肿瘤,通常起源于子宫的间叶细胞。如果不治疗,它可能导致心脏症状和猝死。本病例为 45 岁女性患者,表现为偶发性心悸。影像学方法显示,子宫内可能为不均匀肿块,提示为平滑肌瘤,在动脉期明显强化,通过下腔静脉从卵巢和子宫静脉延伸至心脏。肿瘤委员会将这些发现归因于静脉内平滑肌瘤病伴心内延伸。因此,多学科手术团队仅采用剖腹手术为该患者完全切除心内平滑肌瘤病。ICLM 的治疗金标准是完全切除肿瘤。可以通过从腹部区域进行控制牵引来切除心内肿瘤。