자궁근종 환자에서 정맥과 우심방 혈전의 방사선학적 소견을 보인 정맥내 평활근종

저자는 과거 자궁근중으로 수술한 50세 여자 환자가 심부전 및 광범위한 혈전증의증으로 본원에 내원하여 수술후 정맥내 평활근종으로 밝혀진 증례를 경험하였기에 이를 문헌고찰과 함께 보고하는 바이다. A case of intravenous leiomyomatosis (IVL) invading the vena cava and extending to the right atrium, a rare benign smooth-muscle tumor, is described. Despite their histological benignity these lesions have a tendency to metastasize and are closely related to the condition called "benign metastasizing leiomyoma" and " intracaval mass and cardiac extension" a 50-year old woman was admitted to the hospital with dyspnea beginning 6 months ago and precious history of hysterectomy due to uterne myoma. Echocardiography revealed severe tricupid valve insufficiency and a mobile elongated mass which occupied the inferior vena cava and was extending into the right ventricular cavity. Pelvic ultrasonography and pelvic MRI identified suspicious metastasis to both ovaries and peritoneum. She underwent resection of the cardiac tumor, conomitant tricuspid annuloplasty with a closure of the foramen ovale and both salphyngo-oophorectomy with vaginal stump mass biopsy. All of them could be histologically identified as IVL.