Careaga RG, Vélez PM, Santiago HJA, Valero EG, Soto MP, Cervantez CV

Language: Spanish
References: 40
Page: 30-38
PDF size: 212.88 Kb.

ABSTRACT

Intravenous Leiomyomatosis is an extremely rare uterine neoplasm, characterized by histological benignity, which can occasionally invade through iliac and gonadal veins all the way to the inferior vena cava, even through the right cardiac cavities. Objective: Describe an intravenous leiomyomatosis case with right cardiac cavities invasion through the inferior vena cava (IVC), analyze its frequency, clinical presentation, diagnostic methods and both clinical and surgical criteria for its treatment. Case study: A 45-year-old female has a history of left ooforectomy due to an ovarian cyst in 1994, hysterectomy due to severe myomatosis in 1995, In February 2002 had an acute abdominal pain, treated surgically by laparotomy obtaining a mesenteric tumor classified histological as intravenous leiomyomatosis. A week after, suddenly developed an episode of acute dyspnea and severe hypotension who resolved spontaneously, under the suspicion of acute pulmonary embolism an echocardiogram and contrast - computed tomography and cavography was performed, who showed an inferior vena cava (IVC) tumor that invaded all the way through the right ventricle. Complete excision was achieved employing simultaneous sternotomy and laparotomy under cardiopulmonary bypass and moderate hypothermia. The tumor was removed completely, demonstrated by echocardiographic intraoperative monitorization. The histological report was a benign intravascular leiomyomatosis, under the suspicion of neoplasic emboli she was treated with tamoxifen for sixth months with no complications or relapse.

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