Abstract
Intravenous leiomyomatosis (IVL) extending into the pulmonary artery is very rare. The tumor is usually histologically benign but occasionally causes severe right heart failure, leading to a fatal outcome.
A 45-year-old woman presented to our hospital with abdominal distention and exertional dyspnea. Enhanced computed tomography revealed a tumor originating from the left ovarian vein and extending into the main pulmonary artery through the inferior vena cava (IVC). An echocardiogram also showed an intracardiac mass extending into the pulmonary artery via the right atrium and right ventricular cavity. Mass incarceration into the tricuspid orifice and the main pulmonary artery during systole was a concern. Surgery was performed under cardiopulmonary bypass. We resected the tumor only partially because it was firmly adhered to the wall of the IVC. The comorbid tricuspid regurgitation was simultaneously repaired. The postoperative course was uneventful.
A total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed 3 months after the first surgery. The patient is asymptomatic with no evidence of tumor recurrence 40 months after surgery.
