Our Summary

This research paper discusses a rare, benign tumor called Intracardiac leiomyomatosis (ICLM) that behaves aggressively. Currently, there is no standard treatment, but radical surgery is usually performed to remove these tumors completely. However, in some cases where the complete removal of the tumor isn’t possible, another procedure called bilateral salpingo-oophorectomy (BSO) might be an effective first step. This procedure removes a woman’s ovaries and fallopian tubes, which leads to a decrease in estrogen levels.

The paper shares the case of a 41-year-old woman with an ICLM tumor that couldn’t be fully removed. After having a BSO along with a total hysterectomy and the removal of a mass, a remaining part of the tumor in the patient’s vena cava and right atrium significantly shrank. This was likely due to the decrease in estrogen levels post-BSO.

The researchers conclude that BSO, through its effect of decreasing estrogen levels, may be a good initial treatment for premenopausal women with ICLM tumors that can’t be completely removed.

FAQs

  1. What is Intracardiac leiomyomatosis (ICLM) and how is it typically treated?
  2. What is a bilateral salpingo-oophorectomy (BSO) and how does it work in treating ICLM tumors?
  3. Why is bilateral salpingo-oophorectomy (BSO) considered a potential initial treatment for premenopausal women with ICLM tumors?

Doctor’s Tip

A helpful tip a doctor might tell a patient about salpingo-oophorectomy is to discuss the potential impact of the procedure on hormone levels and the body’s overall health. It’s important for patients to understand the potential long-term effects of having their ovaries and fallopian tubes removed, including the possibility of early menopause and the need for hormone replacement therapy. Patients should also be aware of the potential benefits of the procedure in reducing the risk of certain cancers, such as ovarian and breast cancer. It’s important for patients to have a thorough discussion with their doctor about the risks and benefits of salpingo-oophorectomy before making a decision.

Suitable For

Patients who are typically recommended salpingo-oophorectomy include those with:

  1. Intracardiac leiomyomatosis (ICLM) tumors that cannot be fully removed
  2. Premenopausal women with aggressive benign tumors
  3. Women at high risk for ovarian or fallopian tube cancer
  4. Women with ovarian or fallopian tube cancer
  5. Women with severe endometriosis
  6. Women with a family history of ovarian or breast cancer
  7. Women with genetic mutations such as BRCA1 or BRCA2 that increase the risk of ovarian cancer.

Timeline

Before the salpingo-oophorectomy:

  • Patient is diagnosed with Intracardiac leiomyomatosis (ICLM) tumor that cannot be fully removed
  • Patient undergoes a total hysterectomy and removal of a mass
  • Remaining part of the tumor is found in the vena cava and right atrium

After the salpingo-oophorectomy:

  • Patient undergoes a bilateral salpingo-oophorectomy (BSO)
  • Estrogen levels decrease due to removal of ovaries and fallopian tubes
  • Remaining part of the tumor in the vena cava and right atrium significantly shrinks
  • BSO is considered a good initial treatment for premenopausal women with ICLM tumors that cannot be completely removed

What to Ask Your Doctor

Some questions a patient should ask their doctor about salpingo-oophorectomy include:

  1. Why is a salpingo-oophorectomy being recommended for my condition?
  2. What are the potential risks and complications of the procedure?
  3. How will removing my ovaries and fallopian tubes affect my hormone levels and overall health?
  4. Will I need hormone replacement therapy after the surgery?
  5. How will this procedure impact my fertility and future reproductive options?
  6. What is the expected recovery time and potential side effects after the surgery?
  7. Are there any alternative treatments or therapies that I should consider?
  8. What is the long-term outlook for my condition after undergoing a salpingo-oophorectomy?
  9. How often will I need follow-up appointments and monitoring after the surgery?
  10. Are there any lifestyle changes or precautions I should take post-surgery to support my overall health and well-being?

Reference

Authors: Liang J, Wang L, Ling X, Xie L, Xie M, Huang C. Journal: Am J Case Rep. 2022 Oct 20;23:e937266. doi: 10.12659/AJCR.937266. PMID: 36262031