Article

Intravascular leiomyomatosis: unusual variant of leiomyoma

Basingstoke and North Hamsphire Foundation Trust Hospital Obstetrics and Gynaecology Basingstoke UK
Gynecological Surgery 04/2012; 6(4):399-402. DOI:10.1007/s10397-008-0426-6 pp.399-402

ABSTRACT Leiomyomas (fibroid) arise from the smooth muscle of the myometrium and are benign in nature. Intavascular leiomyomatosis
is an unusual and rare condition where the fibroid grows into the pelvic veins and inferior vena cava and sometimes extends
into the heart chambers. We present a case where a woman presented to us with multiple fibroids and underwent an abdominal
hysterectomy. The diagnosis was not suspected before the surgery but diagnosed on histopathology. The patient underwent further
surgery to remove the fibroids from the pelvic veins and the inferior vena cava. This condition has been reported in only
few case reports around the world. In view of the rarity of this condition, the diagnosis can be easily missed. We suggest
an increased vigilance in women who have large fibroids with unusual features in symptoms or during surgery. Pre-surgical
imaging will help to make diagnosis, and good surgical outcomes can be achieved by a multidisciplinary surgical approach.

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Keywords

case reports
 
fibroid
 
fibroids
 
good surgical outcomes
 
heart chambers
 
histopathology
 
increased vigilance
 
inferior vena cava
 
multidisciplinary surgical approach
 
multiple fibroids
 
myometrium
 
pelvic veins
 
rare condition
 
smooth muscle
 
symptoms
 
unusual
 
unusual features