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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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Scientific Literature, Inc.
2021
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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. |
format | Online Article Text |
id | pubmed-8369432 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | International Scientific Literature, Inc. |
record_format | MEDLINE/PubMed |
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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