Palermo. Collaborative synergy between ARNAS Civico Hospital and ISMETT: rare uterine tumor extending to the heart is removed.

A team that included gynecologists from the Gynecology & Obstetrics and Gynecologic Oncology units of ARNAS Civico in Palermo and ISMETT cardiac surgeons successfully performed an exceptional surgery to remove an intravascular leiomyomatosis, an extremely rare form of uterine fibroid of uncertain malignant potential. This very rare condition originated in the uterus and grew within the pelvic venous system, extending to the inferior vena cava and reaching the heart, with part of the mass protruding inside the right atrium and ventricle. In this case, the use of the LEER (Laterally Extended Endopelvic Resection) technique held a particular scientific significance. This technique is typically used in cases of malignant gynecological tumors resistant to conventional treatment. However, in this instance, it was used for the first time to surgically treat a uterine endovascular formation with systemic development.

“The successful resolution of such a complex case is further testimony to the extremely high standards of care that citizens can expect in our Region, and once again confirms the strong clinical and scientific expertise of our professionals,” said Walter Messina, Director General of ARNAS Civico in Palermo.

“This was a virtuous example of collaboration that highlights the increasingly strategic role of ISMETT within our regional health system,” emphasized Cinzia Di Benedetto, ISMETT Director of Health Care Activities. The cooperation between the two facilities allowed the patient to receive increasingly advanced and cutting-edge care right here in Sicily.”

The combined gynecological–cardiac surgery was decisive for the patient, who is now in good health. “From a gynecological standpoint, a field in which our hospital has a long-standing tradition, the surgery involved an en bloc removal of the uterus and ovaries, and a lateral resection of the endopelvic fascia containing the internal iliac venous plexus, up to its confluence with the common iliac vein,” explained Domenico Cipolla, Director of Health Care Activities of ARNAS Civico.

At the same time, cardiac surgeons from ISMETT removed the intracardiac portion of the tumor through a small incision in the right atrium, without stopping the heart. “The complexity of the procedure required a perfect synergy between gynecological and cardiac surgical expertise,” stressed Marco Morsolini, cardiac surgeon at ISMETT. “The decision to operate with a beating heart, without interrupting the cardiac activity, helped reduce risks and ensured greater safety for the patient. It was an extraordinary example of teamwork that highlighted the outstanding quality of health care facilities in Palermo.”

The patient had a rapid and uneventful postoperative course and will undergo regular follow-up at ARNAS Civico and at ISMETT.