Benign Metastatic Leiomyoma: Unusual Heart Location

S. Elaouni, S. Jebli, S. Sassi, Z. Bernoussi, A. Jahid, F. Zouidia, K. Znati
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Abstract

Cardiac smooth muscle tumors are rare; three different clinical settings for these tumors have been reported, including benign metastasizing leiomyoma from the uterus, primary cardiac leiomyoma and leiomyosarcoma, and intravenous cardiac extension of pelvic leiomyoma, which is the most common. We present a case of a 56-year-old woman with a benign metastasizing leiomyoma to the heart without associated pulmonary localization 15 years after endoscopic vaginal myomectomy of polymyomatous uterus. Immunohistochemical stains for H-Caldesmon, Desmin, and estrogen, progesterone receptors were positive, indicating a smooth muscle tumor of uterine origin. To our knowledge, this is only the fifth reported case of benign metastasizing leiomyoma to the heart with histological proof and the first case of earlier onset cardiac metastasis without pulmonary metastasis localization. It illustrates that benign metastasizing leiomyoma should be included in the differential diagnosis of cardiac tumors in patients with a history of surgery uterine leiomyoma perfectly benign.
良性转移性平滑肌瘤:心脏位置异常
心脏平滑肌肿瘤很少见;据报道,这些肿瘤有三种不同的临床表现,包括子宫良性转移性平滑肌瘤、原发性心脏平滑肌瘤和平滑肌肉瘤,以及最常见的盆腔平滑肌瘤的静脉心脏延伸。我们报告一个56岁的女性,在内镜下阴道子宫肌瘤切除术15年后,出现良性平滑肌瘤转移到心脏,而没有相关的肺部定位。免疫组化染色显示H-Caldesmon、Desmin及雌激素、孕激素受体阳性,提示子宫起源的平滑肌肿瘤。据我们所知,这是第5例有组织学证据的良性转移性心脏平滑肌瘤,也是第一例无肺转移定位的早发性心脏转移病例。提示良性转移性子宫平滑肌瘤应纳入有完全良性子宫平滑肌瘤手术史的心脏肿瘤鉴别诊断。
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