Intravenous leiomyomatosis with inferior vena cava and heart extension
Received 15 December 2008; accepted 15 April 2009. published online 29 June 2009.
Background
Intravenous leiomyomatosis (IVL) is a rare tumor that is histologically benign but biologically malignant. Less than 200 cases of IVL have been reported, most of them were individual reports.
Methods
Six patients with IVL involving the inferior vena cava were analyzed.
Results
Three patients received one-stage operations and two received two-stage operations. All operations were successful. No perioperative death or other complications were observed. Primary tumors and intravenous tumorous emboli were completely resected from four patients. Residual tumor remained in one patient who had serious adhesions due to multiple previous surgeries; however, with antiestrogen therapy, the residual tumor significantly regressed. All patients had tumor relapse after the operation.
Conclusions
IVL should be given more attention by vascular surgeons, although it is extremely rare. Many therapeutic methods are available for uterine leiomyomatosis involving inferior vena cava, among which operation is the best choice.
aDepartment of Vascular Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
bDepartment of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
cDepartment of Cardiac Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
Reprint requests: Changwei Liu, MD, Department of Vascular Surgery, Peking Union Medical College Hospital, 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China
ABSTRACT