Uterine Leiomyoma with Intravenous Leiomyomatosis

Intravenous leiomyomatosis

“…Recognition of the potential of fibroids for venous invasion was accredited to Birch Hirschfeld who described four cases in 1896. 6 However, it was in 1959 when microscopic features were described by Marshall and Morris. Lam et al have recently reviewed the literature and identified 200 reported cases of leiomyomatosis, 68 of which had intracardiac extension.…”

“…In the early stages of venous extension, the diagnosis is often unrecognized and further extension of intravenous leiomyomatosis is not prevented by resection of the primary tumour. 6 This condition is mostly diagnosed in the patients who are present in the 5th and 6th decades of life. Female gonadal steroids play a major role in the pathogenesis as the condition is associated with high estrogen levels.…”

“…6 Surgery can be performed as both single and staged procedures and cardiopulmonary bypass is advocated for resection of tumours with intra-cardiac extension. 5 Although there may be some difficulties in distinguishing such lesions from low-grade sarcomas, they are different histologically from sarcomatosis uteri because the intravenous plug is mainly smooth muscle in origin.…”

Léiomyomatose intravasculaire: une tumeur originale

“…La symptomatologie clinique dépend essentiellement de la localisation de la tumeur. Localisée à l'utérus, elle épouse la sémiologie d'un utérus fibromateux : utérus augmenté de volume [2,[5][6][7][8][9][10], ménomé-trorragies [2,4,6,10], pesanteurs à douleurs pelviennes [4,6,8,9], parfois pollakiurie [4]. En cas d'évolution intraveineuse, la symptomatologie dépend de la topographie de l'extension extra-utérine : au niveau veineux pelvien, on retrouvera des oedèmes des membres inférieurs [8,11,12].…”

“…Localisée à l'utérus, elle épouse la sémiologie d'un utérus fibromateux : utérus augmenté de volume [2,[5][6][7][8][9][10], ménomé-trorragies [2,4,6,10], pesanteurs à douleurs pelviennes [4,6,8,9], parfois pollakiurie [4]. En cas d'évolution intraveineuse, la symptomatologie dépend de la topographie de l'extension extra-utérine : au niveau veineux pelvien, on retrouvera des oedèmes des membres inférieurs [8,11,12]. Si la tumeur atteint le coeur, la patiente présentera des troubles du rythme [3], un souffle cardiaque [9,12,13], voire une insuffisance cardiaque [14][15][16], des syncopes [3,5,13,17] ou mourra de sa pathologie [1].…”