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Intravenous leiomyomatosis

L Grella1, T E Arnold, K H Kvilekval

  • 1Department of Surgery, University Medical Center, State University of New York at Stony Brook 11794-8191.

Journal of Vascular Surgery
|December 1, 1994
PubMed
Summary
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Intravenous leiomyomatosis, a rare smooth muscle tumor, can extend into the heart. This case highlights successful surgical treatment for a patient with cardiac involvement.

Area of Science:

  • Gynecologic Oncology
  • Cardiovascular Surgery
  • Pathology

Background:

  • Intravenous leiomyomatosis (IVL) is a rare benign smooth muscle neoplasm originating in the uterus.
  • IVL characteristically invades pelvic venous channels, posing diagnostic and therapeutic challenges.
  • Cardiac extension of IVL is exceptionally rare, significantly increasing patient morbidity.

Observation:

  • A 45-year-old woman presented with cardiac syncope three months post-hysterectomy.
  • Imaging revealed extensive intravenous leiomyomatosis with cardiac extension.
  • The patient had a history of uterine leiomyomas.

Findings:

  • Diagnosis was confirmed via histopathological examination of surgical specimens.
  • A two-stage surgical approach involving sternotomy and subsequent laparotomy achieved complete tumor resection.

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  • Post-operative recovery was uneventful, with no evidence of recurrence at follow-up.

    • Implications:

    • This case underscores the importance of considering IVL in the differential diagnosis of unexplained pelvic masses and cardiac symptoms.
    • Multidisciplinary surgical management is crucial for successful treatment of IVL with cardiac extension.
    • Early diagnosis and intervention can improve outcomes for this rare condition.