Intracardiac and Intravenous Leiomyomatosis

Ittikorn Spanuchart; Sudarat Satitthummanid; Chalit Cheanvechai; Poonchavist Chantranuwatana; Prasert Trivijitsilp; Pairoj Chattranukulchai; Smonporn Boonyaratavej; Sarinya Puwanant

doi:10.1016/j.jacc.2012.02.088

Journal of the American College of Cardiology

Volume 60, Issue 15, October 2012 DOI: 10.1016/j.jacc.2012.02.088

Intracardiac and Intravenous Leiomyomatosis

Ittikorn Spanuchart, Sudarat Satitthummanid, Chalit Cheanvechai, Poonchavist Chantranuwatana, Prasert Trivijitsilp, Pairoj Chattranukulchai, Smonporn Boonyaratavej, Sarinya Puwanant

Author + information

vol. 60 no. 15 e27

DOI:

https://doi.org/10.1016/j.jacc.2012.02.088

Published By:

Journal of the American College of Cardiology

Print ISSN:

0735-1097

Online ISSN:

1558-3597

History:

Received February 26, 2012
Accepted February 29, 2012
Published online October 9, 2012.

American College of Cardiology Foundation

Author Information

Ittikorn Spanuchart, MD^⁎,^†,
Sudarat Satitthummanid, MD^⁎,^†,
Chalit Cheanvechai, MD^⁎,^‡,
Poonchavist Chantranuwatana, MD^§,
Prasert Trivijitsilp, MD^∥,
Pairoj Chattranukulchai, MD^⁎,^†,
Smonporn Boonyaratavej, MD^⁎,^† and
Sarinya Puwanant, MD^⁎,^†

^⁎
^†
^‡
^§
^∥

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.