Intravenous Leiomyomatosis: The Importance of an Early Diagnosis

Intravenous leiomyomatosis (IVL) is a rare benign smooth muscle neoplasm characterized by intravascular proliferation, often extending from the uterus to the inferior vena cava and right heart. Usually identified incidentally, IVL may present with nonspecific symptoms, including abdominal distension, weight loss, and easy bruising, particularly in women. This case report describes a 47-year-old Caucasian female who presented with progressive abdominal enlargement and other nonspecific symptoms. Imaging revealed a giant tumor occupying the abdominal and pelvic cavities, and exploratory laparotomy was proposed. The surgical intervention involved total hysterectomy and bilateral salpingo-oophorectomy, revealing IVL with extensive involvement of the uterine and para-adnexal tissues. Post-operative recovery was uneventful, and no recurrence was noted over three years of follow-up. This case highlights the importance of recognizing IVL's potential presentations and advocating for timely diagnosis and intervention. Awareness among healthcare professionals is crucial to improve outcomes in patients with this rare entity, which poses potentially severe complications.