case_images: PMC11774521_01
case_images: Fig. 1 (A) Preoperative TTE revealed a 6 x 4 cm moving structure within the right atrium. (B, C) Preoperative contrast-enhanced CT showed a 37-cm-long tumor extending from the right side of the uterine body through the right internal iliac vein and IVC to the right ventricle. TTE: Transthoracic echocardiography; IVC: inferior vena cava
case_images: avd-18-1-24-00084-figure01.jpg
case_images: PMC11774521_01_avd-18-1-24-00084-figure01.jpg
case_images: figure1
case_images: Transthoracic echocardiography (TTE) revealed a 6-cm moving structure within the right atrium (Fig. 1A). Contrast-enhanced computed tomography (CT) showed a 37-cm-long tumor extending from the right side of the uterine body through the right internal iliac vein and inferior vena cava (IVC) to the right ventricle (Figs. 1B and 1C).
case_images: Fig. 2 (A) This is a resected tumor, with a smooth surface of approximately 5 cm in diameter and found to be begin macroscopically. (B) HE stains. Spindle-shaped cells characteristic of leiomyomatosis are observed. (C) Positive for smooth muscle actin. (D) Positive for desmin.
case_images: avd-18-1-24-00084-figure02.jpg
case_images: PMC11774521_01_avd-18-1-24-00084-figure02.jpg
case_images: figure2
case_images: A spherical tumor with a smooth surface of approximately 5 cm in diameter was observed inside the right atrium (Fig. 2A). Histopathological examination confirmed leiomyoma as indicated by the positivity for smooth muscle actin and desmin (Figs. 2B-2D).
case_images: Fig. 3 (A) The abdominal ultrasound test revealed a suspicion of tumor growth in size. (B, C) At the 6-month follow-up CT, the cranial portion of the tumor had grown within the IVC, reaching below the right hepatic vein, raising suspicion of tumor enlargement. IVC: inferior vena cava
case_images: avd-18-1-24-00084-figure03.jpg
case_images: PMC11774521_01_avd-18-1-24-00084-figure03.jpg
case_images: figure3
case_images: The patient was followed up without recurrence or regrowth after the cardiac surgery; however, the 6-month postoperative CT scan revealed a tendency for the uterine leiomyoma to increase in size (Figs. 3A-3C).
case_images: Fig. 4 A resected tumor in the second surgery was shown. The total length of the tumor, including the portion resected during the initial surgery, was 31 cm.
case_images: avd-18-1-24-00084-figure04.jpg
case_images: PMC11774521_01_avd-18-1-24-00084-figure04.jpg
case_images: figure4
case_images: Bilateral salpingo-oophorectomy (BSO), total hysterectomy, and intravascular tumor resection were performed (Fig. 4).