Intravenous leiomyomatosis extending to both pulmonary arteries: the longest tumour

Leiomyomatosis, Uterine tumour

A woman presented with a 50 cm tumour (Fig. 1 ) and it was removed in one stage through incisions in the right atrium (Fig. 2a ), main pulmonary artery (Fig. 2b) and inferior vena cava (Fig. 2c), with the patient under deep hypothermia and cardiac arrest. Diagnosis: intravenous uterine leiomyomatosis with pulmonary arteries extension.

Fig. 1

Resected surgical specimen (RIV and LIV: right and left iliac veins; IVC: inferior vena cava; RA: right atrium; RV: right ventricle; MPA: main pulmonary artery; RPA and LPA: right and left pulmonary arteries).

Fig. 2

(a) Tumour removal through the right atrium (TV: tricuspid valve orifice), (b) excision of the tumour from the main pulmonary artery (MPA), (c) excision of the tumour from the inferior vena cava (IVC).