A 51-year-old patient with hypertension and dyslipidemia under treatment underwent hysterectomy 10 years earlier due to myomatosis.
A year prior to admission, a large abdominal mass was found in routine physical examination. Recently, dyspnea on medium exertion had been added.
Computed axial tomography of the abdomen and pelvis in another center showed the presence of a large pelvic tumor associated with thrombosis of the left iliac vein and IVC to the upper end of the study area.
The impossibility of interrupting the IVC prophylactically for exploratory laparotomy was anticoagulated with coumarins and sent home.
Secondly, in our institution, a new computed tomography was performed that included the thorax, abdomen and pelvis, establishing the diagnosis by demonstrating intravenous growth of a pelvic tumor that reached the right ventricular outflow tract.
The echocardiogram confirmed the tumor and ruled out other cardiac pathologies.
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Similar to the previous case, resection was performed by laparotomy and midline laparotomy, cardiopulmonary bypass and 9-minute circulatory arrest in moderate hypothermia.
The tumor was removed by opening the right atrium, IVC and left iliac; it was not adhered to the walls of the vessels or heart.
The iliac vein was ligated.
In the same act, the pelvic tumor was resected.
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The seventh patient had no complications and was discharged on day one. Aspirin 100 mg and rivaroxaban 10 mg were prescribed for 20 days.
Biopsy revealed leiomyoma with hyaline degeneration.
At 6 months she is asymptomatic.
