Abstract
Leiomyoma is a benign smooth muscle tumor that very rarely becomes cancer. Uterine leiomyoma or uterine fibroid is a benign tumor of uterus arising from smooth muscle cells of myometrium. Intravenous leiomyoma with intracardiac extension is a very rare clinical entity usually develops exclusively in women arising from either uterine venous wall or uterine leiomyoma [1] which is commonly misdiagnosed as primary cardiac tumor, such as Myxoma. We report the case of 48 year old woman with intravenous leiomyoma arising from left common iliac vein and extended to the heart through the inferior vena cava presented with symptoms of hemodynamic disorder. The patient had the history of uterine fibroid. Thoracoabdominal CT was performed to finalize the diagnosis. The intravenous tumor with its extension to the right atrium was ultimately resected via cardiotomy without the need of prolonged hypothermia during cardiopulmonary bypass.
Highlights
After the proper and illustrative diagnosis, it was confirmed that the patient has a leiomyoma with extension to the right atrium
Follow up of the patients in the 3rd month revealed normal and no recurrence of tumor. This case was confirmed as benign leiomyoma extended to the heart based on clinical history, morphological evaluation and histopathological work up. It is known as intravenous leiomyoma (IVL) extended to heart
Since IVL is a rare case, it is usually not in the mind of paractitioners to include in the differential diagnosis of an intracardiac tumor which may lead to the misdiagnosis of the case
Summary
After the proper and illustrative diagnosis, it was confirmed that the patient has a leiomyoma with extension to the right atrium. The right atrium was palpated and felt the tumor. The right atrium was opened carefully and felt the tumor directly with the fingers and checked if there were any adhesions on the right atrial wall. As soon as the tumor was totally pulled out with its tail part from the pelvic veins, the other venous cannula was inserted into the inferior vena cava and established complete Cardio Pulmonary Bypass. Right atrium was checked properly for any tearing and bleeding. Follow up of the patients in the 3rd month revealed normal and no recurrence of tumor
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