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Intravenous leiomyomatosis.

P Konrad¹, L Mellblom

¹Department of Surgery, County Hospital, Kalmar, Sweden.

Acta Obstetricia Et Gynecologica Scandinavica

|January 1, 1989

Summary

Intravenous leiomyomatosis, a uterine smooth muscle neoplasm extending into veins, can be fatal if it reaches the heart. Radical surgical excision is the recommended treatment for this rare condition.

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Area of Science:

Gynecologic Oncology
Vascular Pathology
Surgical Oncology

Background:

Intravenous leiomyomatosis (IVL) is a rare smooth muscle neoplasm originating from the uterus.
It is characterized by vermiform extensions into the venous system, potentially reaching the heart.
While histologically benign, IVL can have a fatal clinical course.

Observation:

This case highlights an incidental diagnosis of IVL during nephrectomy for hydronephrosis.
The tumor extended into the vena cava, presenting as a greyish, worm-like mass.
Tumor tissue tested positive for estrogen and progesterone receptors.

Findings:

Histologically benign, IVL can have a fatal clinical course if it progresses to the heart.
Symptoms are often vague, complicating early diagnosis.
Diagnostic suspicion arises from detecting worm-like intraluminal venous tumors or right-sided cardiac masses.

Implications:

Radical surgical excision of the uterus, ovaries, and all intravenous tumor extensions is the recommended treatment.
Hormone receptor positivity suggests a potential role for hormonal therapies.
Increased awareness is needed for timely diagnosis and improved patient outcomes.

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