Intravenous leiomyomatosis as a rare tumor of myometrium

Česká verzia

Authors: V. Regász ^1,2; Vladimír Boháč ² ; J. Rychnovský ³
Authors place of work: Oddělení patologie, Nemocnice Nový Jičín, primářka MUDr. R. Andělová ; Gynekologicko-porodnické oddělení, Krajská nemocnice T. Bati, Zlín, primář MUDr. Z. Adamík, Ph. D. ¹; Gynekologicko-porodnické oddělení, Středomoravská nemocniční, Přerov, primář MUDr. J. Novota ²
Published in the journal: Ceska Gynekol 2018; 83(1): 53-56

Summary

Aim:
To present a case of a woman diagnosed with intravenous leiomyomatosis of the uterus.

Type of study:
Case report.

Setting:
Department of Obstetrics & Gynaecology, Středomoravská nemocniční a.s., Přerov Hospital.

Case report:
A 39-year old woman was referred to our unit with uterine fibroids, dysfunctional uterine bleeding and anaemia. Abdominal hysterectomy was performed. The histopathological analysis diagnosed the presence of intravenous leiomyomatosis. After a thorough literature review, we decided to perform an adnexectomy. It was not possible to perform this laparoscopically due to adhesions from previous operation. A conversion to open surgery was necessary.

Conclusion:
Intravenous leiomyomatosis is a rare clinical condition characterised by the ability of the leiomyoma to spread outside the uterus via the venous system. The diagnosis is difficult to obtain and can only be made after histopathological examination. There are no universal treatment guidelines in place at present.

Keywords:
intravenous leiomyomatosis, myoma/leiomyoma/fibroid, surgical treatment, hysterectomy, adnexectomy

Zdroje

1. Birch-Hirschfeld, FV. Lehrbuch der Pathologischen Anatomie. 5th ed. Leipzig: FCW Vogel, 1896, 226 S.

2. Du, J., Zhao, X., Guo, D.,et al. Intravenous leiomyomatosis of the uterus: a clinicopathologic study of 18 cases, with emphasis on early diagnosis and appropriate treatment strategies. Hum Pathol, 2011, 42, p. 1240–1246.

3. Kadlecová, J., Hudeček, R., Mekiňová, L., et al. Histologické typy děložních myomů u pacientek v reprodukčním věku a postmenopauze. Čes Gynek, 2015, 80, 5, s. 360–364.

4. Li, R., Shen, Y., Sun, Y., et al. Intravenous leiomyomatosis with intracardiac extension: echocardiographic study and literature review. Tex Heart Inst J, 2014, 41, p. 502–506.

5. Lou, YF., Shi, XP., Song, ZZ. Intravenous leiomyomatosis of the uterus with extension to the right heart. Cardiovasc Ultrasound, 2011, 9, p. 25.

6. Mahmoud, MS., Desai, K., Nezhat, FR. Leiomyomas beyond the uterus; benign metastasizing leiomyomatosis with paraaortic metastasizing endometriosisand intravenous leiomyomatosis: a case series and review of the literature. Arch Gynecol Obstet, 2014, 291, p. 1.

7. Mitsuhasi, A., Nagai, Y., Suqita, M., et al. GnRH agonist for intravenous leiomyomatosis with cardiac extension. A case report. J Reprod Med, 1999, 4410, p. 883-886.

8. Moniaga, MC., Randall, LM. Uterine leiomyomatosis with intracaval andintracardiac extension. Gynecol Oncol, 2012, 2, p. 130–132.

9. Morice, P., Chapelier, A., Dartevelle, P., et al. Late intracaval and intracardiac leiomyomatosis following hysterectomy for benign myomas healed by surgery and GnRH agonist. Gynecol Oncol, 2001, 83, 2, p. 422–423.

10. Nam, MS., Jeon, MJ., Kim, YT., et al. Pelvic leiomyomatosis with intracaval and intracardiac extension: a case report and review of the literature. Gynecol Oncol, 2003, 89, p. 175–180.

11. Norris, HJ., Panmley, T. Mesenchymal tumors of the uterus. V. Intravenous leiomyomatosis: A clinical and pathological study of 14 cases. Cancer, 1975, 36, p. 2164–2178.

12. Palomba, S., Sammartino, A., Di Carlo, C., et al. Effects of raloxifene treatment on uterine leiomyomas in postmenopausal women. Fertil Steril, 2001, 76, p. 38–43.

13. Roztočil, A., et al. Moderní gynekolgie. Praha, Grada, 2011, s. 260.

14. Šimetka, O., Klát, J., Bajsová, S. Možnosti užití selektivních modulátorů progesteronových receptorů v léčbě děložních myomů. Čes Gynek, 2016, 81, 6, s. 452–457.

15. Tomšová, M., Pohnětalová, D., Špaček, J. Vzácné nádory myometria – intravenózní leiomyomatóza a benigní metastazující leiomyom. Čes Gynek, 2007, 72, 2, s. 136–139.

16. Xu, ZF., Yong, F., Chen, YY., et al. Uterine intravenous leiomyomatosis with cardiac extension: Imaging characteristics and literature review. World J Clin Oncol, 2013, 4, p. 25–28.