Clinical analysis of intravenous leiomyomatosis:report of 9 cases / 中国实用妇科与产科杂志

ABSTRACT

OBJECTIVE: To investigate the clinical characteristics,diagnosis and treatment of intravenous leiomyomatosis(IVL).METHODS: The clinical data of 9 IVL treated at Women's Hospital,Zhejiang University School of Medicine from January 2013 to December 2017 were analyzed retrospectively. All the cases were followed up.RESULTS: Out of 8702 patients with uterine leiomyoma,9 patients were diagnosed with IVL. Most patients complained of pelvic mass,and 6 patients had enlarged uterus. Preoperative imaging examination demonstrated parametrial mass in 5 cases. All nine cases were confined to the pelvic cavity except for one who had lung metastasis. Two cases had myomectomy,and seven underwent hysterectomy. The lesions were dendritic,dumbbell-shaped,elliptical or elongate in four cases. Nine cases had a mean follow-up of 28.2 months,and recurrence occurred in two cases.CONCLUSION: The obvious enlargement of uterus and parametrial mass are important features of IVL. It is difficult to diagnose preoperatively. Identifying the morphological features of lesions during operation can improve the diagnostic accuracy. Total hysterectomy is the first choice of treatment and long-term follow-up is also needed.