Intravascular leiomyomatosis (IVL) is a rare benign smooth muscle neoplasm growing within the pelvic venous system, often with caval and intracardiac extension. It frequently coexists with uterine leiomyomas or occurs in women with a history of myomectomy or hysterectomy. IVL is often asymptomatic until intracardiac extension occurs, and carries a risk of sudden death, necessitating timely diagnosis and management. We present a case of IVL diagnosed on hysterectomy specimen with extension to the inferior vena cava found on follow-up imaging. The patient underwent complete resection with multidisciplinary involvement of Gynaecological Oncology and Vascular Surgery and remains disease free following 12 months of follow-up.
<p>Polycystic Ovarian Syndrome (PCOS) is affects 6-10% of women. A cross-sectional study in Auckland showed rates of PCOS in European, Maori and Pacific Island women to be in proportion to the general population. Pacific women had little or no acne but other signs of PCOS were similar among all ethnic groups. Maori and Pacific women were more obese compared to Caucasian women and had highest rates of insulin resistance and lipid abnormalities. This article is based on the treatment options available in the Pacific Islands.</p><p>The main treatment goals are for hyper-androgenic symptoms (hirsutism, acne, scalp hair loss), anovulatory infertility, endometrial protection and management of underlying metabolic abnormalities or metabolic risk factors such as obesity, insulin resistance, dyslipidaemia and IGT. </p>
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