Intravenous leiomyomatosis of the uterus

Intravenous leiomyomatosis (IVL) is a rare neoplasm characterized by nodular masses of histologically benign looking smooth muscle cells growing within uterine or extrauterine venous system.The exact etiology is unclear and benign histological appearance of neoplastic smooth muscles can be deceptive since IVL might behave in a malignant fashion. Total abdominal hysterectomy and excision of any extrauterine tumor if technically feasible is the cornerstone of treatment. We report clinical, histological, and immunohistochemical features of a uterine IVL in a 48 year old lady who presented with menorrhagia. We also elaborate etiopathogenesis and conclude that knowledge about IVL is essential as it must be differentiated from malignant tumors to prevent overtreatment. Long term follow up is recommended in such cases.