[Intravenous leiomyomatosis of the uterus. (A case report)]

A case of the intravenous leiomyomatosis of the uterus in a 53-year-old woman is reported. The patient complained of abdominal enlargement, frequent urination, and a sensation of pressure on the rectum and urinary bladder. Her uterus contained 3 fibroids which ranged from 1.5 to 11 cm in diameter. The largest fibroid contained numerous areas of hydropic degeneration. In the vascular space of the myometrium a polypoid ramifying thrombus 4 x 1 cm was present, arising fom the capsular aspects of large fibroids. It is the smallest tumor reported so far. st could have been overlooked very easily. Only one similar case was found in the literature. The case presented is in agreement with the observation made by Harper i Scully that "intravenous leiomyomatosis may not always appear in obtrusive form" and "that a careful search should be made for it in cases of uterine leiomyoma". The authors analyse the relation between intravenous leiomyomatosis and metastasizing fibroleiomyoma of the uterus. The lesions reported so far suggest that they were well differentiated smooth muscle tumors with a different biologic potential and that they should not be taken as different stages of the same process. It is not suitable to use these terms as synonyms.