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Intravenous Leiomyomatosis: An Uncommon Cause of Pulmonary Embolism

Patient: Female, 39-year-old Final Diagnosis: Intravenous leiomyomatosis Symptoms: Dyspnea • syncope Medication: — Clinical Procedure: — Specialty: Cardiology • Critical Care Medicine • General and Internal Medicine OBJECTIVE: Rare disease BACKGROUND: Intravenous leiomyomatosis (IVL) is a rare benig...

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Autores principales: Kloska, Michal, Patel, Preysi, Soliman, Andrea, Musco, Kaitlyn, Rovella, Jennifer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8369432/
https://www.ncbi.nlm.nih.gov/pubmed/34381010
http://dx.doi.org/10.12659/AJCR.931386
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author Kloska, Michal
Patel, Preysi
Soliman, Andrea
Musco, Kaitlyn
Rovella, Jennifer
author_facet Kloska, Michal
Patel, Preysi
Soliman, Andrea
Musco, Kaitlyn
Rovella, Jennifer
author_sort Kloska, Michal
collection PubMed
description Patient: Female, 39-year-old Final Diagnosis: Intravenous leiomyomatosis Symptoms: Dyspnea • syncope Medication: — Clinical Procedure: — Specialty: Cardiology • Critical Care Medicine • General and Internal Medicine OBJECTIVE: Rare disease BACKGROUND: Intravenous leiomyomatosis (IVL) is a rare benign smooth muscle tumor originating in the uterus or in the uterine vessels. It is characterized by continuous intraluminal growth that may extend through iliac veins and inferior vena cava (IVC) to right chambers of the heart and pulmonary vasculature, leading to life-threatening complications. This case report describes an uncommon cause of non-thrombotic pulmonary embolism in young woman caused by extensive IVL. CASE REPORT: A 39-year-old woman was admitted after multiple syncopal episodes. She was initially found to have a bilateral pulmonary embolism and large right atrial mass believed to be a thrombus. After an unsuccessful attempt to remove the thrombus with AngioVac (AngioDynamics, Latham, NY), subsequent sternotomy revealed a large pedunculated mass extending to the infra-hepatic IVC. Further abdominal imaging showed multiple uterine masses, with the largest about 17 cm, infiltrating the parauterine vessels and extending through the right iliac vein and inferior vena cava up to the right atrium. Pathology examination of the atrial mass revealed benign leiomyoma consistent with further pathology findings after hysterectomy. The pulmonary embolism was believed to be caused by tumor tissue, and anticoagulation was abandoned. Pulmonary nodule raised a suspicion of benign pulmonary metastases, but, fortunately, remained stable during follow-up and the patient had a successful recovery. CONCLUSIONS: Available information about IVL is scarce. This tumor, although benign and rare, should be included in the differential diagnosis of cardiac tumors and non-thrombotic pulmonary emboli in women with predisposing risk factors, as potential complications are life-threatening.
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spelling pubmed-83694322021-08-25 Intravenous Leiomyomatosis: An Uncommon Cause of Pulmonary Embolism Kloska, Michal Patel, Preysi Soliman, Andrea Musco, Kaitlyn Rovella, Jennifer Am J Case Rep Articles Patient: Female, 39-year-old Final Diagnosis: Intravenous leiomyomatosis Symptoms: Dyspnea • syncope Medication: — Clinical Procedure: — Specialty: Cardiology • Critical Care Medicine • General and Internal Medicine OBJECTIVE: Rare disease BACKGROUND: Intravenous leiomyomatosis (IVL) is a rare benign smooth muscle tumor originating in the uterus or in the uterine vessels. It is characterized by continuous intraluminal growth that may extend through iliac veins and inferior vena cava (IVC) to right chambers of the heart and pulmonary vasculature, leading to life-threatening complications. This case report describes an uncommon cause of non-thrombotic pulmonary embolism in young woman caused by extensive IVL. CASE REPORT: A 39-year-old woman was admitted after multiple syncopal episodes. She was initially found to have a bilateral pulmonary embolism and large right atrial mass believed to be a thrombus. After an unsuccessful attempt to remove the thrombus with AngioVac (AngioDynamics, Latham, NY), subsequent sternotomy revealed a large pedunculated mass extending to the infra-hepatic IVC. Further abdominal imaging showed multiple uterine masses, with the largest about 17 cm, infiltrating the parauterine vessels and extending through the right iliac vein and inferior vena cava up to the right atrium. Pathology examination of the atrial mass revealed benign leiomyoma consistent with further pathology findings after hysterectomy. The pulmonary embolism was believed to be caused by tumor tissue, and anticoagulation was abandoned. Pulmonary nodule raised a suspicion of benign pulmonary metastases, but, fortunately, remained stable during follow-up and the patient had a successful recovery. CONCLUSIONS: Available information about IVL is scarce. This tumor, although benign and rare, should be included in the differential diagnosis of cardiac tumors and non-thrombotic pulmonary emboli in women with predisposing risk factors, as potential complications are life-threatening. International Scientific Literature, Inc. 2021-08-12 /pmc/articles/PMC8369432/ /pubmed/34381010 http://dx.doi.org/10.12659/AJCR.931386 Text en © Am J Case Rep, 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Kloska, Michal
Patel, Preysi
Soliman, Andrea
Musco, Kaitlyn
Rovella, Jennifer
Intravenous Leiomyomatosis: An Uncommon Cause of Pulmonary Embolism
title Intravenous Leiomyomatosis: An Uncommon Cause of Pulmonary Embolism
title_full Intravenous Leiomyomatosis: An Uncommon Cause of Pulmonary Embolism
title_fullStr Intravenous Leiomyomatosis: An Uncommon Cause of Pulmonary Embolism
title_full_unstemmed Intravenous Leiomyomatosis: An Uncommon Cause of Pulmonary Embolism
title_short Intravenous Leiomyomatosis: An Uncommon Cause of Pulmonary Embolism
title_sort intravenous leiomyomatosis: an uncommon cause of pulmonary embolism
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8369432/
https://www.ncbi.nlm.nih.gov/pubmed/34381010
http://dx.doi.org/10.12659/AJCR.931386
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