Abstract

Case Report

Intravenous Leiomyomatosis of the Uterus with Intracardiac Extension

Tomas Reyes-del Castillo*, Minerva I Hernandez-Rejon, Jose L Ruiz-Pier, Mario Peñaloza-Guadarrama, Carlos E Merinos-Avila, Cristina Juarez-Cabrera, Pedro A del Valle-Maldonado, Sofia Ley-Tapia and Valentín Gonzalez-Flores

Published: 22 July, 2025 | Volume 9 - Issue 1 | Pages: 003-007

Background: Intravascular Leiomyomatosis (IVL) is an often misdiagnosed rare benign mesenchymal tumor characterized by the presence of vascular extension and invasion of smooth muscle cells in a serpiginous-like pattern, first originating in uterine smooth muscle cells. Its growth pattern can involve both ovarian veins, the inferior vena cava, and even reach the right atrium/ventricle in 45% of the cases. The incidence has been reported to be 0.25 to 0.40% of patients with uterine leiomyoma, with about 300 cases reported in the literature. Also, since the tumor is hormone-dependent, most affected individuals are premenopausal women in middle age. Optimal treatment for IVL is complete surgical removal with hysterectomy and oophorectomy, independent of stage. The most frequent perioperative complications are hemorrhage due to tumoral hypervascularization, embolism, and the usual laparotomy complications. We present the case of a 51-year-old female with IVL stage 3 with complete single-stage surgical resolution.

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References

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