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EP761 Incidentally detected intravenous leiomyomatosis limited to uterus: a case report
  1. E Uyanık,
  2. G Özten,
  3. OC Zaim,
  4. M Gültekin and
  5. MC Salman
  1. Hacettepe University, School of Medicine, Ankara, Turkey


Introduction/Background Uterin leiomyoma is a benign smooth muscle neoplasm originates from myometrium and the most common pelvic tumor. Among leiomyoma variants, intravenous leiomyomatosis (IVL) is a benign tumor originated from smooth muscle and proliferating within the uterin or extrauterin vessels. Tumor can spread to iliac veins, inferior cava vein, heart or pulmoner arteries via uterin veins. Early diagnosis is difficult and unless cardiac spread occurs, it is asymptomatic. Besides symptoms such as dispnea, pleuretic chest pain, and syncope, it can even lead to cardiac arrest and without treatment it can be fatal.

Methodology In this case report patient with IVL is presented.

Results A 54 year old postmenaposal women presented to our clinic with abdominal pain. A mass extending to umblicus is detected with abdominal examination. On ultrasound examination, uterus was larger than usual and filled with myomas. Total abdominal histerectomy and bilateral salpingooferectomy was performed. Pathology reported IVL and thoracal and abdominal tomography was performed to evaluate extrauteine vessels and heart for invasion. In CT, there wasn’t leiomyomatosis in venous system and heart and patient discharged.

Conclusion IVL, even though rare, is a a serious disease that can be fatal. Although disease was diagnosed after pathological evaluation in our case, imaging is essential in diagnosis. Tumor spreading to big vessels, heart or pulmoner arteries can cause severe symptoms like dispnea, syncope and aritmias. Today, surgery is the only effective treatment method and tumor must be completely excised to prevent recurrence. Excision of fibroids only may be recommended in patients with fertility desire, but total excision of pelvic structures is more accepted due to the risk of recurrence. Although originally benign, it should be kept in mind that the disease may cause life threatening complications and therefore patients should be kept under close monitoring.

Disclosure Nothing to disclose.

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