JACC. Case reports · 2025
Benign Metastasizing Leiomyoma Presenting as a Right Ventricular Mass.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Romano Edoardo, Schütze Jonathan, Schönhoff Florian, Siegenthaler Franziska, Banz Yara, Gräni Christoph
Аннотация
BACKGROUND: Masses in the right ventricle are uncommon, but if present, they are most often attributed to either primary cardiac tumors or metastatic disease.
CASE SUMMARY: A 50-year-old woman presented with progressive lower extremity edema and was diagnosed with a right ventricular mass causing severe tricuspid insufficiency and near-total obstruction of the pulmonary artery. She had a history of hysterectomy for uterine leiomyomatosis. Based on imaging and histological findings, a diagnosis of benign metastasizing leiomyoma (BML) was made. The patient underwent successful resection of the mass, tricuspid valve replacement, and implantation of a right ventricle-pulmonary artery conduit.
DISCUSSION: Cardiac metastasis from BML is extremely rare, particularly in the right heart. Although histologically benign, BML can lead to life-threatening cardiac complications. This case emphasizes the importance of thorough cardiac assessment in patients with a history of leiomyoma and unexplained symptoms. Early diagnosis and surgical management are essential to prevent serious outcomes.
TAKE-HOME MESSAGES: BML, though rare, can cause life-threatening cardiac involvement. Clinicians should consider a comprehensive cardiac evaluation for patients with unexplained cardiac symptoms and a history of leiomyoma.
CASE SUMMARY: A 50-year-old woman presented with progressive lower extremity edema and was diagnosed with a right ventricular mass causing severe tricuspid insufficiency and near-total obstruction of the pulmonary artery. She had a history of hysterectomy for uterine leiomyomatosis. Based on imaging and histological findings, a diagnosis of benign metastasizing leiomyoma (BML) was made. The patient underwent successful resection of the mass, tricuspid valve replacement, and implantation of a right ventricle-pulmonary artery conduit.
DISCUSSION: Cardiac metastasis from BML is extremely rare, particularly in the right heart. Although histologically benign, BML can lead to life-threatening cardiac complications. This case emphasizes the importance of thorough cardiac assessment in patients with a history of leiomyoma and unexplained symptoms. Early diagnosis and surgical management are essential to prevent serious outcomes.
TAKE-HOME MESSAGES: BML, though rare, can cause life-threatening cardiac involvement. Clinicians should consider a comprehensive cardiac evaluation for patients with unexplained cardiac symptoms and a history of leiomyoma.