Intracardiac Leiomyoma Leading to Liver Failure and Heart Failure Managed by VA-ECMO and Surgical Resection.

BACKGROUND

Intracardiac leiomyomatosis (ICL), a rare condition characterized by intracardiac tumors, can be associated with uterine leiomyomas. Early diagnosis is crucial due to the risk of severe cardiac complications.

CASE SUMMARY: A 52-year-old woman presented with severe liver failure and heart failure caused by a large right ventricular leiomyoma. The patient was managed with venoarterial extracorporeal membrane oxygenation (ECMO) support and subsequent surgical resection of the tumor. Histological examination confirmed a benign smooth muscle tumor.

DISCUSSION: This case highlights the challenges in diagnosing and managing ICL, particularly when presenting with multiorgan failure. ECMO served as a vital bridge to surgery. ICL should be considered in patients with right-sided intracardiac masses, especially with a history of hysterectomy.

TAKE-HOME MESSAGES: ICL is a rare, but life-threatening, condition of intracardiac tumors. Early diagnosis and aggressive management, including ECMO as a bridging therapy, are crucial for improved outcomes.