Post-hysterectomy intravenous leiomyomatosis: A case of successful multidisciplinary surgery under non-extracorporeal circulation

Abstract

Intravenous leiomyomatosis is a rare benign disease. We here in present the case of a 39-year-old woman with a history of hysterectomy who presented with intermittent abdominal pain, palpitations and tightness of the chest. Physical examination revealed the presence of a pelvic mass of regular shape. Gynecological ultrasonography, computed tomography scans and three-dimensional (3D) cardiac ultrasonography were used to evaluate the imaging characteristics of the mass and reach a final diagnosis. The mass appeared to extend to the iliac veins, renal veins and inferior vena cava on imaging examination. The mass was successfully excised under non-extracorporeal circulation in one stage. Pathological examination of tumor samples indicated intravenous leiomyomatosis. After the operation, the symptoms were dissipated and no abnormal echo was observed in the inferior vena cava or the right atrium on 3D-cardiac ultrasonography. The patient is currently followed up without signs of recurrence. The aim of the present study was to describe in detail the diagnostic procedure and treatment in order to improve our current understanding of this disease.

Natural history of leiomyomas beyond the uterus

“…There are reports in which the extension pathway occurred through the right ovarian vein [8,10,19–21] or bilaterally. [20,22–24]…”