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Long-term outcomes of surgical treatment for intravascular leiomyomatosis

Authors :
Hsi-Yu Yu
Hsiao-En Tsai
Nai-Hsin Chi
Kuan-Ting Kuo
Shoei-Shen Wang
Chi-An Chen
Yih-Sharng Chen
Source :
Journal of the Formosan Medical Association, Vol 117, Iss 11, Pp 964-972 (2018)
Publication Year :
2018
Publisher :
Elsevier, 2018.

Abstract

Background: Intravascular leiomyomatosis (IVL) is relatively rare. The optimal surgical method and long-term outcomes are not completely understood. Methods: Medical records between 2007 and 2017 in our hospital were analyzed to identify IVL cases with surgical intervention. Their medical records, operative details, and follow-up were collected by chart review and telephone communication. Results: Eight patients with IVL were included in the study, accounting for 0.26% of all uterine leiomyoma cases. Primary IVL was confined to pelvic cavity in three patients, extended to the inferior vena cava (IVC) below renal vein in one, reached IVC and right atrium in three, and reached main pulmonary artery in one. One-stage operation was performed for seven patients. Cardiopulmonary bypass was done in four patients, and aortic cross-clamp and temporary circulatory arrest was performed in two patients. None of the four patients with intrapulmonary tumors received concomitant pulmonary tumor resection. There was no operative mortality and four morbidities, including ureter injury (2), bladder injury (1), and femoral vein thrombosis (1). During follow-up, two patients exhibited local recurrence of the tumor in the pelvis, and one patient had rapidly growing intrapulmonary tumor three months post-operatively. Intrapulmonary tumors in the other three patients remained stationary at 6, 84, and 120 months post-operatively. Conclusion: One-stage operation to completely remove IVL is feasible and with good long-term outcomes, which is recommended if the patient can tolerate the operation. Concomitant intrapulmonary tumors can be followed up watchfully except when associated with pleural effusion or the pathology indicating trend of increasing malignancy. Keywords: Intravascular leiomyomatosis, Intracardiac leiomyomatosis, Cardiac tumor, Surgery, Cardiopulmonary bypass, Follow-up

Subjects

Subjects :
Medicine (General)
R5-920

Details

Language :
English
ISSN :
09296646
Volume :
117
Issue :
11
Database :
Directory of Open Access Journals
Journal :
Journal of the Formosan Medical Association
Publication Type :
Academic Journal
Accession number :
edsdoj.7387e59253064b2cab4b5196fdddf954
Document Type :
article
Full Text :
https://doi.org/10.1016/j.jfma.2018.08.023