J. Rabasa , C. Forcada , A. Casarramona , P. Calvillo , I. Valls , M.A. Jimenez , A. Elguezabal , A. Tarrats , S. Martinez
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Intravenous leiomyomatosis: Case report and review of the literature
Introduction
We retrospectively reviewed a case of a 42-year-old woman with intravenous leiomyomatosis.
Clinical findings
The present study describes a case of IVL extending into the right internal and common iliac veins.
Diagnosis
The patient was diagnosed by definitive pathological examination after a hysterectomy and double salpingectomy. Hypovolaemic shock due to delayed intraperitoneal bleeding from the ovarian vessels pedicle was observed. An emergent laparotomy for haemostasis was performed. A follow-up MRI, 2 months later, showed a polylobulated mass extending inside the right internal and common iliac veins.
Intervention and result
The patient underwent a third laparotomic procedure with the removal of the right pelvic mass together with the involved veins. The postoperative course was uneventful, and the patient remains well at 3-month follow-up, with no signs of lower limb edema or venous disorders.
Conclusion
Intracardiac leiomyomatosis is mostly diagnosed in premenopausal women. The most severe manifestation could be a vascular thrombosis or a right atrial tumor in the case of intracardiac involvement. Early and appropriate diagnosis is essential for optimal treatment. Surgery is the best treatment.
期刊介绍:
Una excelente publicación para mantenerse al día en los temas de máximo interés de la ginecología de vanguardia. Resulta idónea tanto para el especialista en ginecología, como en obstetricia o en pediatría, y está presente en los más prestigiosos índices de referencia en medicina.