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A one-stage approach to the treatment of intravenous leiomyomatosis extending to the right heart  Pietro Rispoli, MD, Davide Santovito, MD, Caterina Tallia,

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Presentation on theme: "A one-stage approach to the treatment of intravenous leiomyomatosis extending to the right heart  Pietro Rispoli, MD, Davide Santovito, MD, Caterina Tallia,"— Presentation transcript:

1 A one-stage approach to the treatment of intravenous leiomyomatosis extending to the right heart 
Pietro Rispoli, MD, Davide Santovito, MD, Caterina Tallia, MD, Gianfranco Varetto, MD, Massimo Conforti, MD, Mauro Rinaldi, MD  Journal of Vascular Surgery  Volume 52, Issue 1, Pages (July 2010) DOI: /j.jvs Copyright © 2010 Society for Vascular Surgery Terms and Conditions

2 Fig 1 (A, B, C) Leiomyoma extending from the external left iliac vein to the right atrium (preoperative). (D, E, F) Tumor removed and absence of recurrence (22 months postoperative). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

3 Fig 2 (A) Beginning of midline laparotomy and partial view of the operative field, including the distal segment of the sternotomy incision. (B) The tumor is pulled out from inside the right atrium and gently stretched, then interrupted as distally as possible. (C) The distal vena cava and the first tract of the left common iliac vein (1); the right common iliac artery suspended on umbilical tape (2); the inflow point of the left hypogastric vein (3), and the left external iliac vein (4). (D) After venotomy of the distal vena cava, the common iliac vein, and the first segment of the external iliac vein, the tumor is pulled down from the upside and freed from dense adherences arising from the inflow point of the hypogastric vein, which is tied. (E) The venotomy is closed with a Prolene 6–0 surjet. (F) The tumor is shown after complete removal. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

4 Fig 3 Histological study (A, B). Hematoxylin and eosin-stained tissue sections. Muscular fascicles with fusate cells and vessels inside the mass (arrows). Immunochemical study (C, D). Actin stain and desmin-stained tissue sections. Bundles of brown muscular cells, which are typical of leiomyomatosis. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

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