Single-stage laparotomy for intracardiac leiomyomatosis without open-heart surgery: a case report

Intracardiac leiomyomatosis is a rare leiomyoma that originates from the uterus. It can be easily misdiagnosed because of its nonspecific manifestations. In this case, we aim to emphasize the complete resection of the ICL with a single-stage laparotomy.

Here, we report a case of a 36-year-old female who presented with dyspnea and a mobile tumor in the right atrium that was detected in transthoracic echocardiography prior to cosmetic surgery. The results of computed tomography (CT) scan, Cardiovascular magnetic resonance (CMR), and magnetic resonance venography (MRV) revealed a mass in the IVC extending into the right atrium and pelvic veins. One-stage surgery, along with transesophageal echocardiography monitoring, was performed for the patient, and the tumor was resected entirely without the need for open-heart surgery.

This case report suggests that, in selected cases, one-stage surgery through laparotomy for resecting intravenous leiomyomatosis may be a safer and more efficient approach in comparison with the traditional two-stage operation, due to fewer complications. Based on our case, anticoagulant therapy may also be essential to reduce the risk of embolism during this single-stage laparotomy. Further studies are needed to validate the efficacy and safety of this approach.