Journal of the American College of Cardiology
Intracardiac and Intravenous Leiomyomatosis
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- Received February 26, 2012
- Accepted February 29, 2012
- Published online October 9, 2012.
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A 43-year-old woman with a history of syncope was referred for open heart surgery for right atrial (RA) myxoma removal. On examination, she had a grade 2/6 systolic ejection murmur. Intraoperative transesophageal echocardiogram revealed a mobile lobulated mass (A and B, arrowheads; Online Videos A and B) extending from the inferior vena cava (IVC) (C, asterisk; Online Video C) to the RA and protruding through the tricuspid valve into the right ventricle (RV). At surgery, a 30-cm long cordlike tumor (D) extending from the IVC and ovarian veins into the RA was removed. The histology examination revealed smooth muscle cell proliferation (E) consistent with intravenous leiomyomatosis. A hysterectomy was subsequently performed, and histologically revealed uterine leiomyoma (F). Intravenous or intracardiac leiomyomatosis is a rare benign smooth muscle cell tumor arising from a venous wall or a uterine leiomyoma. This case highlights that intracardiac leiomyomatosis should be considered, in addition to extended cancer or thrombus, in a female patient presenting with a right-side cardiac mass extending from the IVC.
- Received February 26, 2012.
- Accepted February 29, 2012.
- American College of Cardiology Foundation