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Vega B, Stockland AH, Bramblet RM, et al. A case of a large leiomyomatous uterus with multiple arteriovenous malformations and subsequent high cardiac output state with severe four chamber cardiac enlargement. Gynecol Oncol Rep. 2021;38:100898doi: 10.1016/j.gore.2021.100898.
Vega, B., Stockland, A. H., Bramblet, R. M., Anderson, A. L., Mankad, R., Khan, Z., Mustafa, M., Steyermark, J. M., Fields, A. R., Berntson, N. J., Kenneth Schoolmeester, J., Colglazier, J. J., & Bakkum-Gamez, J. N. (2021). A case of a large leiomyomatous uterus with multiple arteriovenous malformations and subsequent high cardiac output state with severe four chamber cardiac enlargement. Gynecologic oncology reports, 38100898. https://doi.org/10.1016/j.gore.2021.100898
Vega, Beatriz, et al. "A case of a large leiomyomatous uterus with multiple arteriovenous malformations and subsequent high cardiac output state with severe four chamber cardiac enlargement." Gynecologic oncology reports vol. 38 (2021): 100898. doi: https://doi.org/10.1016/j.gore.2021.100898
Vega B, Stockland AH, Bramblet RM, Anderson AL, Mankad R, Khan Z, Mustafa M, Steyermark JM, Fields AR, Berntson NJ, Kenneth Schoolmeester J, Colglazier JJ, Bakkum-Gamez JN. A case of a large leiomyomatous uterus with multiple arteriovenous malformations and subsequent high cardiac output state with severe four chamber cardiac enlargement. Gynecol Oncol Rep. 2021 Nov 26;38:100898. doi: 10.1016/j.gore.2021.100898. eCollection 2021 Nov. PMID: 34926776; PMCID: PMC8651894.
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Gynecol Oncol Rep. 2021 Nov 26;38:100898. doi: 10.1016/j.gore.2021.100898. eCollection 2021 Nov.

A case of a large leiomyomatous uterus with multiple arteriovenous malformations and subsequent high cardiac output state with severe four chamber cardiac enlargement.

Gynecologic oncology reports

Beatriz Vega, Andrew H Stockland, Rachel M Bramblet, Alexandra L Anderson, Rekha Mankad, Zaraq Khan, Mohamed Mustafa, Joan M Steyermark, Amanda R Fields, Novette J Berntson, J Kenneth Schoolmeester, Jill J Colglazier, Jamie N Bakkum-Gamez

Affiliations

  1. Mayo Clinic Alix School of Medicine, Rochester, MN, United States.
  2. Department of Radiology, Mayo Clinic, Rochester MN, United States.
  3. Division of Gynecology Oncology Surgery, Mayo Clinic, Rochester, MN, United States.
  4. Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States.
  5. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States.
  6. Division of Reproductive Endocrinology and Infertility, Mayo Clinic, Rochester, MN, United States.
  7. Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, United States.
  8. Department of Genetics, Mayo Clinic, Rochester, MN, United States.
  9. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States.
  10. Division of Vascular and Endovascular Medicine, Mayo Clinic, Rochester, MN, United States.

PMID: 34926776 PMCID: PMC8651894 DOI: 10.1016/j.gore.2021.100898

Abstract

Uterine arteriovenous malformations (AVMs) are rare and potentially life-threatening. They can be congenital or acquired. Uterine artery embolization or hysterectomy are considered mainstays of management. AVMs can be associated with leiomyomas, and patients may require both procedures. We present a case of a 42-year-old woman with a massively enlarged leiomyomatous uterus supplied and drained by multiple large AVMs, leading to high cardiac output state with severe four chamber cardiac dilation. Management required a multidisciplinary team of interventional radiology, gynecologic oncology surgery, vascular surgery, cardiac anesthesiology, cardiology, and urology and a 2-day interventional approach of preoperative arterial embolization followed by hysterectomy.

© 2021 The Authors.

Keywords: Fibroid; Fumarate hydratase deficiency; Leiomyoma; Uterine arteriovenous malformation; Uterine artery embolization

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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