A 57-year-old female, with diagnosis of dyslipidemia and medical history of posterior deep vein thrombosis, after resection of extravascular leiomyoma in the right atrium, and partial section of the inferior vena cava. She went to the clinic for evaluation due a possible uterine-dependent pelvic tumor, classified as probable uterine myxomatosis. After US, and CT, was diagnosed as a solid retroperitoneal mass of pyriform shape with dimensions of 95 x 37 mm. During the surgical time, the deep iliac vein was identified, which presented a 9 x 5 cm tumor. with stenosis at 2 cm from the bifurcation of the inferior vena cava, and proximal dilatation... Was a right iliac vein-dependent retroperitoneal pelvic tumor...so we thought on a leiomyoma but the histopathological study revealed a neurilemoma or schwannoma with no specific origin...
I have not excpiriece like that in my surgical practice even in literature.
Thank you for your answers
As you both expressed; we do not have knowledge of the existence of a case about a "schwannoma" originated at a vein in the currently medical literature, for that reason we had considered the existence of a "leiomyoma of venous origin". However, the pathologist´s report expressed the diagnosis of confirmation as neurilemmoma; as we all know, the neurilemmoma forms part of a subclass proper to soft tissue tumors (eg, GIST, schwannoma, leiomyoma, etc.), for this reason we have considered that either histological report was erroneous.
In addition, I must mention about the existence of 3 similar cases in the literature, but 2 were classified as leiomyomas and only 1 as cardiac neurilemmoma.
1. Doganci S, Kaya E, Kadan M, Karabacak K, Erol G, Demirkilic U. Huge Intravascular Tumor Extending to the Heart: Leiomyomatosis. Case Reports in Surgery, vol. 2015, Article ID 658728, 3 pages, 2015. doi:10.1155/2015/658728
2. Gui T, Qian Q, Cao D, Yang J, Peng P, Shen K. Computerized tomography angiography in preoperative assessment of intravenous leiomyomatosis extending to inferior vena cava and heart. Cancer (2016) 16:73
3. Early SA, McGuinness J, Galvin J, Kennedy M, Hurley J. Asymptomatic schwannoma of the heart. Journal of Cardiothoracic Surgery 2007, 2:1
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