Multimodality treatment of two cases of intracardiac leiomyomatosis with enormous mass in the abdominopelvic cavity

Abstract

Difficulties in the preoperative preparation and surgical management of patients with intravenous leiomyomatosis involving the heart and pulmonary artery resulting in intracardiac leiomyomatosis necessitate further investigation of this condition. In this report, we describe the interdisciplinary treatment of two cases of intracardiac leiomyomatosis with enormous mass in the abdominopelvic cavity. A single-stage surgical procedure with a combined thoracic and abdominal approach was performed in both cases and the tumors were successfully excised. The procedure also involved removal of the atrial, caval and other venular extensions, and total hysterectomy with bilateral salpingo-oophorectomy. Postoperative pathology findings confirmed the diagnosis of intravenous leiomyomatosis. Neither patient died perioperatively, and no complications were observed.

Keywords::

• intravenous leiomyomatosis
• intracardiac leiomyomatosis
• multimodality therapy

Acknowledgments

Management of the two patients described in this report involved surgeons and clinicians from ten different departments of Zhongshan Hospital, Fudan University (Shanghai, China). The authors acknowledge the contributions of B Xie and H Tong from the Department of General Surgery; L Zhang from the Department of Urologic Surgery; Y Jiang from the Department of Radiology; J Chen and G Gong from the Department of Interventional Radiation; X Zhuang and Z Xue from the Department of Anesthesiology; and L Xia and D Xu from the Department of Cardiac Surgery, all of whom contributed equally to the surgery. The authors also thank Y Hou for her pathologic review. The final manuscript was revised by Y Zhou from the Department of Medical Oncology.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Editorial assistance was provided by Content Ed Net Co. Ltd. (Shanghai, China).