血管内平滑肌瘤病累及右心房及下腔静脉1例  

Intravascular leiomyomatosis involving right atrium and inferior vena cava:a case report

作　　者：关青艳 何秀超[2] 于迎春 郭英 GUAN Qingyan;HE Xiuchao;YU Yingchun;GUO Ying(The Fourth Clinical Medical College,Xinjiang Medical University,Urumqi,830000,China;The First Hospital,Lanzhou University;Xinjiang Jiayin Hospital)

机构地区：[1]新疆医科大学第四临床医学院,乌鲁木齐830000 [2]兰州大学第一医院 [3]新疆佳音医院

出　　处：《临床心血管病杂志》2018年第11期1139-1141,共3页Journal of Clinical Cardiology

摘　　要：1病例资料 患者,女,49岁,主诉＂胸闷、心悸8个月余,加重伴双下肢水肿1个月余＂,患者于入院前8个月余无明显诱因出现胸闷、气促、心悸,活动后腹部胀痛,偶有咳嗽、咳痰,患者未予重视,入院前1个月余以上症状加重伴双下肢水肿。专科检查：胸骨左缘第3、4肋间闻及肿瘤扑落音,心尖区闻及收缩期杂音。2017年6月6日心脏彩超示下腔静脉及右房内占位性病变（图1a、b）。Intravascular leiomyomatosis（IVL）involving in the right atrium and inferior vena cava is rare.Its growth pattern is similar to malignant tumor,which is easily misdiagnosed.This article reports an ultrasound examination of the inferior vena cava and right atrial space-occupying lesions,considering myxoma,but CT and MRI examination showed multiple leiomyomas of the uterus,lesions spread along the right ovarian vein-inferior vena cava-right atrium,which is diagnosed as IVL.This patient was treated with surgery.The surgical plan was followed by multidisciplinary surgery.The endoscopic hysterectomy and the inferior vena cava right abdomen mass removal were performed under cardiopulmonary bypass.The patient＇s general condition was good after surgery,and there was no recurrence after regular follow-up after discharge.Differential diagnosis with other diseases,preoperative tumor range assessment,and surgical debridement are key to the success and prognosis of IVL surgery.

关 键 词：血管内平滑肌瘤病 子宫平滑肌瘤 

分 类 号：R543[医药卫生—心血管疾病]