IV Leiomyomatosis on FDG PET/CT

Abstract

A 48-year-old woman presented with a 2-month history of right lower extremity edema. Clinical examination only showed right lower limb swelling. Routine laboratory examination revealed no abnormal results. Abdominal ultrasonography identified uterine leiomyoma and soft tissue masses. An abdominal CT demonstrated a continuous mass extending from the right internal and external iliac vein into the common iliac vein and inferior vena cava. To distinguish the mass from malignancy, the patient underwent PET/CT scan which showed increased FDG activity in the mass. However, histopathological examination proved the mass to be IV leiomyomatosis.

Clinical analysis of uterine intravenous leiomyomatosis: A retrospective study of 260 cases

“… 20 In the middle stage, it extends out of the pelvic cavity to the renal vein or inferior vena cava and can gradually lead to edema and heaviness of the lower extremities. 21 In the late stage, it reaches the right atrium or the pulmonary artery, and chest discomfort, dyspnea and syncope develop, 22 and as the condition worsens, congestive heart failure occurs, 23 even pulmonary embolism 24 and sudden death. 25 All 260 of our patients were in the early stages, 55% had abdominal masses and 22% were asymptomatic.…”

Update on clinical characteristics and molecular insights for uterine intravenous leiomyomatosis (Review)

“…All these common presenting complaints are similar to those of uterine leiomyomas. As the tumor grows out of the pelvic cavity, reaching the renal vein and inferior vena cava, patients experience edema and heaviness of the lower extremities (27). Acute Budd-Chiari syndrome, with shortness of breath, bilateral diffuse lower extremities, ascites, edema and hepatomegaly, has been reported in several patients as a result of tumor thrombosis (28).…”