Tribondeau P, Avril A, Guyon F, Bussières E, Stöckle E, Becat A
Service de Chirurgie, Institut Bergonié, Bordeaux.
J Gynecol Obstet Biol Reprod (Paris). 1997;26(2):187-92.
A case of intravenous leiomyomatosis of the uterus with extension into the heart discovered in a 34-year old patient who suffered from dyspnea is reported. The findings suggest that intravenous leiomyomatosis originates from the smooth muscle component of uterine veins. Only 30 cases of intravenous leiomyomatosis with intracardiac extension have been reported. Two-dimensional echocardiography showed an abnormal mass in the right atrium. Pelvic echography showed an abnormal mass in the pelvis. In case of cardiac involvement, spontaneous prognosis remains poor. The primary goal of surgery is the complete removal of the tumor. Hormonotherapy should also be considered in case of unresectable residual tumor. A long-term follow-up of patients after resection of intravenous leiomyomatosis is needed because recurrences up to 17 years after primary resection have been reported.
报告了一名34岁患有呼吸困难的患者,其子宫静脉内平滑肌瘤病延伸至心脏。研究结果表明,静脉内平滑肌瘤病起源于子宫静脉的平滑肌成分。仅有30例静脉内平滑肌瘤病伴有心脏内延伸的病例被报道。二维超声心动图显示右心房有异常肿块。盆腔超声检查显示盆腔有异常肿块。若心脏受累,自然预后仍然很差。手术的主要目标是完全切除肿瘤。对于无法切除的残留肿瘤,也应考虑激素治疗。静脉内平滑肌瘤病切除术后需要对患者进行长期随访,因为有报道称初次切除后长达17年仍有复发。