Successful operative treatment of uterine leiomyoma with extensive intravenous extension to the IVC, right heart, and pulmonary arteries

Acta Chir Belg. 2019 Jun;119(3):182-185. doi: 10.1080/00015458.2018.1427839. Epub 2018 Jan 17.

Abstract

Introduction: Intravenous extension of benign uterine leiomyomata ('fibroids'), in the absence of discrete metastatic disease has rarely been reported. 'Fibroids' remain one of the most common premenopausal uterine pathologies.

Methods and results: We report the diagnosis and multidisciplinary led operative management of a 52-year-old woman with a histologically benign, but biologically aggressive, uterine leiomyoma with intravenous extension to the inferior vena cava (IVC), right heart and pulmonary arteries.

Conclusions: Total abdominal hysterectomy and bilateral salpingo-oophorectomy combined with exploration of the sub-hepatic IVC and heart under deep hypothermic circulatory arrest achieved its successful macroscopic clearance.

Keywords: IVC; Uterine leiomyoma; fibroid; intracardiac extension; intravascular extension.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Heart Arrest, Induced
  • Heart Neoplasms / pathology
  • Heart Neoplasms / secondary*
  • Heart Neoplasms / surgery*
  • Humans
  • Hysterectomy
  • Leiomyoma / pathology
  • Leiomyoma / surgery*
  • Middle Aged
  • Pulmonary Artery / pathology
  • Pulmonary Artery / surgery*
  • Salpingo-oophorectomy
  • Uterine Neoplasms / pathology
  • Uterine Neoplasms / surgery*
  • Vascular Neoplasms / pathology
  • Vascular Neoplasms / secondary*
  • Vascular Neoplasms / surgery*
  • Vena Cava, Inferior / pathology
  • Vena Cava, Inferior / surgery*