Intravenous leiomyomatosis

A case of intravenous leiomyomatosis is presented along with a review of the literature. The condition is a neoplasia of smooth muscle originating from the uterus, with vermiform extensions into veins. Although histologically benign, the clinical course can be fatal if intravenous tumor progresses to the heart. Ordinary leiomyomas of the uterus are frequently coexistent. The symptoms are usually vague. The diagnosis should be suspected when a worm-like, greyish tumor with a smooth surface is found in cut vessels or when right-sided cardiac tumors are detected. Radical excision of the uterus and ovaries, as well as of the intravenous tumor extensions is recommended. In our case the tumor extended into the vena cava. The diagnosis was incidental during nephrectomy due to hydronephrosis. Tumor tissue was positive for estrogen and progesterone cytosolic receptors.