Intravenous leiomyomatosis of the uterus: A clinicopathological analysis of nine cases and literature review

Taiwan J Obstet Gynecol. 2017 Jun;56(3):362-365. doi: 10.1016/j.tjog.2017.04.017.

Abstract

Objective: Intravenous/intravascular leiomyomatosis is characterized by intravenous proliferation of a histologically benign smooth muscle cell tumor mass that is non-tissue-invasive. Although benign, intravenous leiomyomatosis may cause remarkable systematic complications, presents significant diagnostic difficulties, and also is characterized by a relatively increased possibility of recurrence. We determine patients' characteristics, and recurrence and treatment of intravenous leiomyomatosis.

Materials and methods: Prognostic factors are analyzed with univariate analysis. Differences in categorical data are evaluated by the X2 test. A P value below 0.05 is regarded as indicating a significant difference.

Results: The data results accord with the widely held view that complete excision of intravenous leiomyomata achieves favorable prognoses regarding remission. The efficacy of using Gonadotropin releasing hormone agonists to prevent growth or recurrence of tumors in unresected or incompletely resected intravenous leiomyomatosis foci.

Conclusion: If complete surgical resection is not possible, partial resection followed by hormone therapy using gonadotropin-releasing hormone agonists is recommended, which in this study achieved the same favorable prognosis with regard to remission.

Keywords: GnRH-A; Hysterectomy; Intravenous/intravascular leiomyomatosis; Leiomyoma.

Publication types

  • Multicenter Study
  • Review

MeSH terms

  • Adult
  • Female
  • Gonadotropin-Releasing Hormone / therapeutic use*
  • Humans
  • Hysterectomy
  • Leiomyomatosis* / diagnosis
  • Leiomyomatosis* / drug therapy
  • Leiomyomatosis* / pathology
  • Leiomyomatosis* / surgery
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology
  • Risk Factors
  • Uterine Neoplasms* / diagnosis
  • Uterine Neoplasms* / drug therapy
  • Uterine Neoplasms* / pathology
  • Uterine Neoplasms* / surgery
  • Vascular Neoplasms* / diagnosis
  • Vascular Neoplasms* / drug therapy
  • Vascular Neoplasms* / pathology
  • Vascular Neoplasms* / surgery
  • Veins

Substances

  • Gonadotropin-Releasing Hormone