PATHOLOGY & ONCOLOGY RESEARCHVol. 4 No. 1, 1998

 Report

Intravenous Leiomyomatosis of the Uterus

A Report of Three Cases

Liliana ALA ANDRADE1, Renato Z TORRESAN2, José FS SALES Jr2, Regina VICENTINI2, Gustavo A DE SOUZA2

1Department of Pathology, Faculdade de Ciencias Médicas, Universidade Estadual de Campinas, UNICAMP, Campinas, Brazil
2Department of Gynecology, Faculdade de Ciencias Médicas, Universidade Estadual de Campinas, UNICAMP, Campinas, SP, Brazil

 

Three cases of intravenous leiomyomatosis (IVL) of the uterus, a rare benign smooth-muscle tumor, are described. A preoperative diagnosis of IVL was not made in any of the patients, all of which presented with a pelvic mass with the presumptive diagnosis of leiomyoma. Surgical exploration confirmed the presence of uterine mass and two of the three cases showed extra-uterine extension into the ovarian or uterine veins. Histological examination demonstrated a fascicular pattern of bland spindle-shaped smooth-muscle cells, which extended to veins inside the myometrium or to extrauterine veins. This was confirmed by immunohistochemical stain for desmin and factor VIII. Despite their histological benignity, these lesions have a tendency to metastasize and are closely related to the conditions called ''benign metastasizing leiomyoma'' and ''intracaval mass and cardiac extension''. The primary treatment of IVL is hysterectomy and excision of any extrauterine tumor, when technically feasible. Anti-estrogenic therapy has been suggested as potentially useful in controlling of unresectable tumor. According to the literature, the follow-up must be long and periodic postoperative ultrasonic or magnetic nuclear resonance imaging studies may be useful in detecting growth of residual intravascular tumor. Pathology & Oncology Research, Vol 4, Nr 1, 44-47, 1998

Key words: uterine tumor; intravenous leiomyomatosis


Received: Oct 2, 1997; accepted: Nov 15, 1997
Correspondence: Liliana ALA ANDRADE, Department of Pathology, Faculdade de Ciencias Médicas, Universidade Estadual de Campinas, UNICAMP, Campinas 13083-970, Brazil; Tel: +55 19 2393897, Fax: +55 19 2393897; E-mail: anatpat@turing.unicamp.br

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