Display options
Cite
Schultz KL, Quinn SM, Miller AH, et al. Point of care ultrasound facilitated diagnosis of right ventricular mass as the etiology of syncope; A case report of intravenous leiomyomatosis. Radiol Case Rep. 2021;16(6):1288-1293doi: 10.1016/j.radcr.2021.02.062.
Schultz, K. L., Quinn, S. M., Miller, A. H., Fieman, R. E., Cipolle, M. D., Misselbeck, T. S., & Roth, K. R. (2021). Point of care ultrasound facilitated diagnosis of right ventricular mass as the etiology of syncope; A case report of intravenous leiomyomatosis. Radiology case reports, 16(6), 1288-1293. https://doi.org/10.1016/j.radcr.2021.02.062
Schultz, Kristine L, et al. "Point of care ultrasound facilitated diagnosis of right ventricular mass as the etiology of syncope; A case report of intravenous leiomyomatosis." Radiology case reports vol. 16,6 (2021): 1288-1293. doi: https://doi.org/10.1016/j.radcr.2021.02.062
Schultz KL, Quinn SM, Miller AH, Fieman RE, Cipolle MD, Misselbeck TS, Roth KR. Point of care ultrasound facilitated diagnosis of right ventricular mass as the etiology of syncope; A case report of intravenous leiomyomatosis. Radiol Case Rep. 2021 Mar 28;16(6):1288-1293. doi: 10.1016/j.radcr.2021.02.062. eCollection 2021 Jun. PMID: 33854666; PMCID: PMC8026911.
Copy Download .nbib Format: NLM
Share it on

Radiol Case Rep. 2021 Mar 28;16(6):1288-1293. doi: 10.1016/j.radcr.2021.02.062. eCollection 2021 Jun.

Point of care ultrasound facilitated diagnosis of right ventricular mass as the etiology of syncope; A case report of intravenous leiomyomatosis.

Radiology case reports

Kristine L Schultz, Shawn M Quinn, Andrew H Miller, Rachel E Fieman, Mark D Cipolle, Timothy S Misselbeck, Kevin R Roth

Affiliations

  1. Department of Emergency and Hospital Medicine, Lehigh Valley Health Network/University of South Florida Morsani College of Medicine, Lehigh Valley Campus, Cedar Crest Boulevard & I-78, Allentown PA 18103, USA.
  2. Department of Surgery, Lehigh Valley Health Network/University of South Florida Morsani College of Medicine, Lehigh Valley Campus, Cedar Crest Boulevard & I-78, Allentown PA 18103, USA.

PMID: 33854666 PMCID: PMC8026911 DOI: 10.1016/j.radcr.2021.02.062

Abstract

Syncope is a common emergency department (ED) chief complaint. Rarely, syncope can be the result of right ventricular outflow obstruction from an intracardiac tumor, such as an intracardiac extension of intravenous leiomyomatosis (IVL). Typically, this type of tumor is confined to the pelvic veins, but in very rare cases, it can extend through the inferior vena cava into the right atrium. Point-of-care ultrasound (POCUS) can be a crucial tool in the ED for identifying intracardiac tumors presenting as syncope and expediting clinical management. We present the case of a 39-year-old female with no prior medical history that presented to the ED having experienced dyspnea on exertion and two syncopal episodes prior to ED admission. POCUS use in the ED elucidated the presence of a right atrial mass and further imaging showed a mass on the patient's uterus. After surgical removal of a portion of the atrial mass, a subsequent biopsy revealed it had leiomyoma-like features; as such, the patient was diagnosed with IVL. This case illustrates the importance of using POCUS in the ED to help determine the etiology of syncope. Although intracardiac extensions of IVL are rare, it is important for emergency physicians to keep this diagnosis in the differential in patients with symptoms or risk factors suggestive of IVL with intracardiac extension.

© 2021 The Authors. Published by Elsevier Inc. on behalf of University of Washington.

Keywords: Intracardiac tumors; Intravenous leiomyomatosis; Point-of-care ultrasound; Syncope differential; Syncope etiology

References

  1. CJEM. 2012 Mar;14(2):106-12 - PubMed
  2. Clinics (Sao Paulo). 2012;67(1):83-7 - PubMed
  3. Cardiovasc Surg. 1995 Dec;3(6):693-6 - PubMed
  4. Int J Clin Exp Med. 2015 Jul 15;8(7):11602-6 - PubMed
  5. J Vasc Surg. 2004 Feb;39(2):465-9 - PubMed
  6. J Vasc Surg. 2010 Apr;51(4):1000-2 - PubMed
  7. Ann Thorac Surg. 2010 May;89(5):1641-3 - PubMed
  8. Ann Emerg Med. 2007 Apr;49(4):431-44 - PubMed
  9. J Vasc Surg. 2010 Jul;52(1):212-5 - PubMed
  10. Anaesth Crit Care Pain Med. 2017 Dec;36(6):383-389 - PubMed
  11. Obstet Gynecol. 2012 Dec;120(6):1400-6 - PubMed
  12. Mol Clin Oncol. 2016 Nov;5(5):604-606 - PubMed
  13. Tex Heart Inst J. 2005;32(2):232-4 - PubMed
  14. Ann Vasc Surg. 2006 May;20(3):405-7 - PubMed
  15. J Reprod Med. 1999 Oct;44(10):883-6 - PubMed
  16. Medicine (Baltimore). 2019 Aug;98(35):e16913 - PubMed
  17. J Vasc Surg. 2009 Oct;50(4):897-902 - PubMed
  18. Angiology. 2007 Jun-Jul;58(3):376-9 - PubMed
  19. Ann Thorac Surg. 2017 Feb;103(2):e145-e147 - PubMed
  20. Surg Oncol. 2013 Sep;22(3):e44-52 - PubMed
  21. Int J Cardiol. 2016 Nov 15;223:91-92 - PubMed
  22. Am J Obstet Gynecol. 2009 Dec;201(6):574.e1-5 - PubMed
  23. Echo Res Pract. 2016 Dec;3(4):R65-R77 - PubMed

Publication Types