Intravenous leiomyomatosis of the uterus with extension to the right heart

Lou, Yiting; Shi, Xinping; Song, Ze–Zhou

doi:10.1186/1476-7120-9-25

Cited by 35 publications

(32 citation statements)

References 20 publications

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“…In total, ∼90% of reported cases have occurred in parous females and 10% of patients have presented with a history of previous pelvic surgery and hysterectomy (4). It has been suggested that an incomplete hysterectomy may promote the proliferation of IVL (5), or alternatively, that IVL may originate in the smooth muscle cells of the vessel wall (6). The present study patient had a normal pregnancy and delivered via cesarean section four years earlier.…”

Section: Discussionmentioning

confidence: 99%

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Detection of intravenous leiomyomatosis with intracardiac extension by ultrasonography: A case report

Liu

Xue

2013

Oncology Letters

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Intravenous leiomyomatosis (IVL) is characterized by histologically benign tumors that exhibit aggressive clinical behavior. On rare occasions, the tumors may extend into the regional and systemic veins, thus reaching the heart. This may subsequently cause intracardiac leiomyomatosis (ICL), which may lead to congestive heart failure and occasionally, sudden fatalities. Due to its rarity and diffuse symptoms, the misdiagnosis of ICL is common and as a result, the condition may be under-reported. The present study reports a 33-year-old female who was admitted to Shandong Provincial Hospital Affiliated to Shandong University for myomectomy due to a rapidly growing myoma of the uterus. In routine pre-operative abdominal ultrasonography, a moderately sized echoic mass in the right internal iliac vein was observed, which extended to the common iliac vein, the inferior vena cava and the orifice of the right atrium. A presumptive diagnosis of ICL was made. The patient underwent a well-prepared one-stage thoraco-abdominal surgical procedure and the pathological report confirmed ICL. This case illustrates that the early detection of ICL may prevent a potential emergency situation and abdominal ultrasonography may be considered a useful tool in the diagnosis of ICL.

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Section: Discussionmentioning

confidence: 99%

“…It is most commonly observed in middle-aged females (5) and in conjunction with leiomyoma of the uterus or an ovarian tumor (8). Two-thirds of patients exhibit diffuse symptoms, including pelvic discomfort or abdominal pain; however, IVL may also be diagnosed accidentally during abdominal US, unrelated surgeries or at autopsy (9).…”

Section: Discussionmentioning

confidence: 99%

Detection of intravenous leiomyomatosis with intracardiac extension by ultrasonography: A case report

Liu

Xue

2013

Oncology Letters

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“…Intravenous leiomyomatosis is a rare histologically benign intravascular tumor of uterine origin, and the most commonly affected patients are premenopausal and multiparous females aged 20 to 70 years, with a mean age of 45 (8). The clinical course of the disease is variable and is determined by the position and scale of the neoplasm.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Ultrasonographic Features and Clinical Findings for Intravenous Leiomyomatosis: A Case Report

Wang³

2017

Iran Red Crescent Med J

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Introduction: To summarize the vascular ultrasonographic features of intravenous leiomyomatosis (IVL) and assess the role of this method for the accurate diagnosis of patients with IVL. The current study was carried out in Shandong provincial hospital affiliated to Shandong university and Shandong medical imaging research institute, Shandong university of Jinan, Shandong province, P.R. China in 2017. Case Presentation: The 9 samples of IVL were collected from patients undergone surgery from July 2007 to December 2016 in the department of gynecology of the hospital. The clinical data, vascular ultrasonographic findings, and histologic results were retrospectively reviewed. Six patients underwent computed tomography (CT) and 3 patients were examined by magnetic resonance imaging (MRI). Clinical symptoms included lower extremity edema, chest congestion, and syncope. Any pelvic masses found were identified. On ultrasonography, the internal iliac vein, common iliac vein, and the inferior vena cava (IVC) were all involved with dilated veins and isoechoic masses noted in all 9 patients. The right ovarian vein was involved in 2 patients, and in 3 patients, masses had emerged in the IVC and spread into the right atrium, at times intruding into the tricuspid orifice during diastole. All 9 patients underwent a 1-stage thoracoabdominal surgical procedure. There was no documented recurrence of the masses in 7 patients and in the remaining 2 patients; solid pelvic masses were detected 3 or 6 months after the surgery. No intravascular masses were detected. Conclusions: Ultrasonography is performed to evaluate the features and path of extension of IVL. Patients diagnosed with uterine leiomyoma or hysterectomy were at greater risk of developing IVL. Vascular ultrasound could be used as an additional diagnostic tool for IVL screening and diagnosis in patients at an early age.

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“…36 Benign smooth muscle fibers invade the venous channels of the pelvis and, even though they grow slowly, they might grow into the vena cava and right heart and cause these unusual symptoms. Surgical intervention with primary excision and follow-up antiestrogen therapy for prevention is recommended to treat these cases.…”

Section: Cardiac Symptom and Atypical Symptoms Secondary To Vascular mentioning

confidence: 98%

Typical and atypical clinical presentation of uterine myomas

Su¹,

Lee²,

Cheng³

et al. 2012

Journal of the Chinese Medical Association

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Myoma is the most common benign neoplasm that can occur in the female reproductive system, most frequently seen in women in their 50s. Although the majority of myomas are asymptomatic, some patients have symptoms and/or signs of varying degrees. Typical myoma-related symptoms or signs include: (1) menstrual disturbances like menorrhagia, dysmenorrhea and intermenstrual bleeding, (2) pelvic pain unrelated to menstruation, (3) compression symptoms, similar to a sensation of bloatedness, urinary frequency and constipation, (4) subfertility status such as recurrent abortion, preterm labor, dystocia with an increased incidence of Cesarean section, and postpartum hemorrhage, and (5) cosmetic problems due to increased abdominal girth However, there are undoubtedly some clinical presentations secondary to uterine myomas are not so specific, such as: (1) uncommon compression-related symptoms, (2) cardiac symptom and atypical symptoms secondary to vascular involvement or dissemination, (3) abdominal symptoms mimicking pelvic carcinomatosis, (4) dyspnea, (5) pruritus, (6) hiccup or internal bleeding, and (7) vaginal protruding mass or uterine inversion. Familiarization with these symptoms and awareness of other unusual or atypical presentations of uterine myomas will remind clinical practitioners of their significance, and of the necessity of follow-up examinations and individualized management to fit the needs and childbirth desires of the patients.

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Intravenous leiomyomatosis of the uterus with extension to the right heart

Cited by 35 publications

References 20 publications

Detection of intravenous leiomyomatosis with intracardiac extension by ultrasonography: A case report

Detection of intravenous leiomyomatosis with intracardiac extension by ultrasonography: A case report

Cardiovascular Ultrasonographic Features and Clinical Findings for Intravenous Leiomyomatosis: A Case Report

Typical and atypical clinical presentation of uterine myomas

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