Abstract
Purpose This study aimed to retrospectively review the diagnosis and surgical treatment of uterine intravenous leiomyomatosis (IVL). Methods The clinical data of 14 patients with uterine IVL admitted to our hospital between 2013 and 2018 were retrospectively analyzed, including their demographics, imaging results, surgical procedures, perioperative complications, and follow-up results. Results The tumors were confined to the pelvic cavity in 7 patients, 1 into the inferior vena cava, 4 into the right atrium, and 2 into the pulmonary artery (including 1 into the superior vena cava). Only one case was misdiagnosed as right atrial myxoma before the operation, which was found during the surgery and was treated by staging surgery; all the other patients underwent one-stage surgical resection. Three patients underwent complete resection of the right atrial tumor through the abdominal incision, and one patient died of heart failure in the process of resection of heart tumor without abdominal surgery. During the 6–60 months of follow-up, 4 patients developed deep venous thrombosis of the lower extremity, and 1 patient developed ovarian vein thrombosis and pulmonary embolism. After anticoagulation treatment, the symptoms disappeared. One patient refused hysterectomy and the uterine fibroids recurred 4 years after the operation. Conclusion Specific surgical plans for uterine IVL can be formulated according to cardiac ultrasound and computed tomography (CT). For the first type of tumor involving the right atrium, the right atrium tumor can be completely removed through the abdominal incision alone to avoid thoracotomy. The disease is at high risk of thrombosis and perioperative routine anticoagulation is required.
Highlights
Uterine intravenous leiomyomatosis (IVL) is an uncommon uterine smooth muscle tumor which is defined as an intraluminal growth and extension of benign smooth muscle from the intrauterine venules upward to varying distances, including the pelvic veins, the inferior vena cava, the right atrium, and pulmonary artery [1, 2]
Gynecological ultrasound and echocardiography were performed for all patients, and an enhanced computed tomography (CT) examination was performed for patients with uterine IVL involving inferior vena cava or heart
We found that the tumor was originated from the inferior vena cava, in a free state in the right atrium, extending into the right ventricle and pulmonary artery, and adhering to the right ventricle. en, we considered it as the IVL
Summary
Uterine intravenous leiomyomatosis (IVL) is an uncommon uterine smooth muscle tumor which is defined as an intraluminal growth and extension of benign smooth muscle from the intrauterine venules upward to varying distances, including the pelvic veins, the inferior vena cava, the right atrium, and pulmonary artery [1, 2]. Diagnosis of this disease is difficult owing to its insidious onset and when symptoms appear, the tumor is often involved in the right atrium and even the pulmonary artery, causing serious consequences [3].
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
