Abraham Abey S, Marsic Teuta, Das Gyan, Mehta Anand
Cardiothoracic Anesthesiology, Cleveland Clinic Foundation, Cleveland, USA.
Cureus. 2023 Aug 19;15(8):e43764. doi: 10.7759/cureus.43764. eCollection 2023 Aug.
Intravenous leiomyoma is a rare condition that occurs when there is a vascular invasion of a pre-existing uterine leiomyoma. The tumor can metastasize to structures such as the heart and lungs. We discuss a case of metastasis to the heart resulting in severe tricuspid regurgitation. Surgical intervention is the primary modality; usually a staged approach involving cardiac surgery along with abdominal and/or pelvic surgery. We want to highlight the importance of fully investigating right-sided cardiac masses. While there are common etiologies for these masses, one must maintain a high degree of suspicion for an intravenous leiomyoma, especially if a female has certain risk factors such as a prior history of fibroids or a hysterectomy. We also stress the importance of a multi-disciplinary team approach when providing care to these patients, along with reviewing all modalities of imaging.
静脉内平滑肌瘤是一种罕见的病症，发生于既有子宫平滑肌瘤出现血管侵袭时。肿瘤可转移至心脏和肺等结构。我们讨论了一例转移至心脏导致严重三尖瓣反流的病例。手术干预是主要治疗方式；通常采用分阶段方法，包括心脏手术以及腹部和/或盆腔手术。我们想强调全面检查右侧心脏肿块的重要性。虽然这些肿块有常见病因，但对于静脉内平滑肌瘤必须保持高度怀疑，尤其是女性有某些危险因素，如既往肌瘤病史或子宫切除术史。我们还强调在为这些患者提供护理时采用多学科团队方法的重要性，同时要复查所有影像学检查方式。
