Experience in management of intravenous leiomyomatosis with inferior vena cava extension

Abstract

To evaluate the diagnostic and treatment of intravenous leiomyomatosis (IVL) with extension to inferior vena cava. The clinical data of 6 cases of IVL involving inferior vena cava were analyzed retrospectively. Three of the 6 patients underwent phase I operation, and 2 underwent phase II operation, all successfully; and 1 did not undergo operation sue to poor cardio-pulmonary function. No peri-operative death and complication were observed. The primary tumor and intravenous tumor embolus were completely resected in 4 out of the 6 patients. One patient who had serious adherence between the tumor and pelvic cavity due to multiple operations had some residual tumors left. However, after anti-estrin treatment, the residual tumors had obviously regressed. All the patients had relapsed after the operation. IVL is very rare. The vascular surgeon must pay more attention to this disease. There are many therapeutic methods to choose when the IVL involves the inferior vena cava, among which operation is the best choice. Completely resection of the tumor is the key of the prevention of recurrence.