累及心脏的静脉内平滑肌瘤病8例临床分析

Intravenous Leiomyomatosis with Intracardiac Extension : A Report of 8 Cases

目的:探讨累及心脏的静脉内平滑肌瘤病的诊断与治疗。方法:回顾性分析2006年10月至2011年12月我院收治的8例心脏受累的静脉内平滑肌瘤病患者的临床资料。结果:8例患者的中位年龄47岁,影像学检查及手术证实8例患者累及心脏。4例表现为心慌、胸闷、气短等症状;1例出现月经期延长;3例无特殊症状。5例患者有子宫肌瘤病史,其中3例既往行子宫切除术,1例既往行子宫肌瘤剔除术。7例患者接受一期手术,1例仅行下腔静脉和右心房肿瘤切除术。随访7例患者1个月～5年,1例保留卵巢的患者在术后2个月复发。结论:借助影像学检查充分评估静脉平滑肌瘤病病变范围,完整切除肿瘤及术后密切随诊可以改善其预后。

Objective：To explore the diagnostic features and therapeutic methods of intravenous leiomyo- matosis with intracardiac extension. Methods; Eight patients diagnosed with intravenous leiomyomatosis with intracardiac extension between 2006 -2011 in Capital Medical University affiliated An Zhen Hospital were ret- rospectively analyzed. Results： The median age at presentation was 47-year-old. Eight patients with intracar- diac extension were confirmed both by imaging and by surgery. Five patients presented with cardiac Symp- toms, 1 with menorrhagia and 3 without obvious symptoms, Five patients had a history of uterine myoma and 4 underwent previous surgical treatment： 3 with hysterectomy and 1 with myomectomy. Seven patients were treated with single-stage operation and 1 with intracaval and intracardiac tumor excision. Seven of eight pa- tients had been followed up and their follow-up time varied from 1 month to 5 years. One case of recurrence was reported after two monthes after ovary-reserving operation. Conclusions： The improved prognosis of in- travenous leiomyomatosis patients with intracardiac extension is depended on comprehensively imaging ex- amination, complete resection of tumor and intensive follow-up after operation as well.