Vanishing intravenous leiomyomatosis after hysterectomy: Assessment of the need to perform complete resection

Abstract

Intravenous leiomyomatosis (IVL) is a rare smooth muscle tumor that may extend into extrauterine veins. A high IVL recurrence rate has been reported after hysterectomy. A 44-year-old woman underwent total hysterectomy as a result of uterine leiomyoma, and IVL within the left uterine vein was incidentally found during the surgery. A residual tumor within the right ovarian vein was detected on contrast-enhanced computed tomography (CT) two days postoperatively. The tumor was diagnosed as IVL because it showed contrast enhancement on preoperative magnetic resonance imaging by retrospective re-interpretation. However, the tumor completely disappeared on contrast-enhanced CT without any medical treatment five months postoperatively. This is the first report of spontaneous regression of IVL. Postsurgical imaging was important to determine the residual extrauterine extension of IVL when it was incidentally found during gynecologic surgery. A hysterectomy alone may be adequate in selected cases, but long-term follow-up imaging is strongly recommended in all cases.

Uterine intravenous leiomyomatosis with an isolated large metastasis to the right atrium: a case report

“…Of note, the intracardiac tumor in the present case was larger than the diameter of the inferior vena cava and, thus, was considered to have developed within the heart. This differs from the report by Maneyama et al [9] in which a spontaneous migration of a residual IVL to the heart, via the blood stream after hysterectomy, was described. The intracardiac tumor of the present case was adherent to the wall of the right atrium wall via a richly vascularized pedicle.…”

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

“…However, recent studies revealed that TH was sufficient, and bilateral oophorectomy was not associated with recurrence. 11,13,31 To determine the influence of different surgical types on recurrence, we analyzed our 166 regularly followed up patients. Fourteen eventually relapsed after a median follow-up of 36 months, and their detailed information is shown in Table S1.…”

A Rare Case of Cardiac Metastatic Uterine Intravenous Leiomyomatosis

“…The pelvic and venous masses in a typical IVL are continuous. Though its pathogenesis is unclear, possible theories include its origin from blood vessel wall (smooth muscle) or uterine fibroids invasion into the uterine vein with significant widespread ( 8 ). The IVL may grow along blood vessels, extending to the iliac vein, inferior vena cava, and even the heart ( 8 ).…”

“…Though its pathogenesis is unclear, possible theories include its origin from blood vessel wall (smooth muscle) or uterine fibroids invasion into the uterine vein with significant widespread ( 8 ). The IVL may grow along blood vessels, extending to the iliac vein, inferior vena cava, and even the heart ( 8 ). There have been reports that IVL spontaneously migrates toward the heart through the bloodstream after hysterectomy.…”