A Case of Huge Metastatic Diaphragmatic Leiomyoma with Right Atrial Thrombosis

Abstract

A benign metastasizing leiomyoma is a very rare presentation. It is mainly found in female who have a surgical history of uterine leiomyoma. We present a rare case of a huge diaphragmatic metastasizing leiomyoma with right atrial thrombosis. A 47-year-old female visited the cardiothoracic surgery outpatient department because of recurring neck swelling and pain. Contrast-enhanced computed tomography of the neck revealed acute thrombus in the right brachiocephalic vein and acute thrombophlebitis in the superior vena cava, left brachiocephalic vein, and internal jugular vein. Incidental right pleural effusion and large hepatic mass were detected. Low-molecular-weight heparin was used to improve thrombosis before surgery, and a chest tube was inserted to improve right pleural effusion. A large subphrenic tumor originating from the right diaphragm was removed and no liver invasiveness was detected. After surgery she treated using anticoagulant and thrombosis was decreased.