The Teaching Point

Uterine intravenous leiomyomatosis (UIL) can extend into the IVC and right cardiac chambers causing right-sided heart failure and potentially massive pulmonary embolism; a woman with a history of uterine leiomyomas presenting with signs and symptoms of right-sided heart failure and evidence of pulmonary embolism should be assessed for uterine intravenous leiomyomatosis as a potential diagnosis. CTA is the best diagnostic investigative tool to assess the location and size, and highlight the vascular extension of UIL, and can be used as first-line imaging technique because the time required for examination is short.






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From the manuscript

Multidisciplinary approach in the management of uterine intravenous leiomyomatosis with intracardiac extension: case report and review of literature

Free full text article: Multidisciplinary approach in the management of uterine intravenous leiomyomatosis with intracardiac extension: case report and review of literature

Abstract
Uterine intravenous leiomyomatosis is an uncommon tumor, usually arising from the uterus, with nodular masses which extend intravascularly over variable distances and may reach the inferior vena cava, right atrium, and pulmonary arteries. Early diagnosis and surgical intervention are crucial as intracardiac leiomyomatosis not only causes cardiac symptoms but may result in pulmonary embolism and sudden death. Complete tumor resection is key in disease management, thus rendering cardiac-extending uterine intravenous leiomyomatosis one of the most challenging conditions for surgical treatment. The use of interventional radiology procedures can facilitate the surgical approach. We report the case of a massive pelvic recurrence of uterine leiomyomatosis with intracardiac extension and pulmonary embolism, analyzing management and surgical outcomes, highlighting the role of interventional radiology during the therapeutic pathway. Nonetheless, there are currently very few data available concerning the use of interventional radiology procedures in the therapeutic strategy of uterine intravenous leiomyomatosis with intracardiac extension.






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1. Uterine intravenous leiomyomatosis

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