Introduction The morphology of intravenous leiomyomatosis is similar to uterus leiomyoma, however, it often exhibits clinical features of malignant tumor: invasive growth, lung and peritoneal metastasis, tumor thrombi in the lumen of veins. The aim of our study was to evaluate the features of the clinical course and to develop the surgical treatment tactic.
Materials The study involved 43 patients with intravenous leiomyomatosis, who underwent treatment in our clinic in 2010–2019.
Results Intravenous leiomyomatosis predominantly developed in reproductive and pre-menopause periods. Most patients (75,6%) had history of uterus leiomyoma. The group with non-intracardiac leiomyomatosis included 25 patients, with intracardiac – 18.
In the group of intracardiac intravenous leiomyomatosis the tip of the thrombus extended to the right atrium in 8 patients, to ventricle – in 8 patients, to pulmonary arteries - in 2 patients. In 6 patients the tumor thrombus extended from pelvis through internal iliac veins, in 6 – through ovarian veins, in 6 – through ovarian veins and internal iliac veins. The extent of surgery was hysterectomy with bilateral salpingo-oophorectomy, complete cytoreduction and thrombectomy. The surgery was performed in 10 patients by sternolaparotomic access, in 8 – by laparotomic. Two patients underwent surgery without cardiopulmonary bypass. Among 16 patients operated with cardiopulmonary bypass, the parallel extracorporeal circulation was used in 5 cases. All procedures were performed in one-stage approach. All patients are alive with no evidence of disease.
Conclusion This study is important step forward to the understanding of clinical course and developing the surgical management standards of disease.
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