Intravenous leiomyomatosis:A report of 3 cases and literature review

Objective To study the diagnosis and treatment of intravenous leiomyomatosis（IVL）. Methods Clinical and pathologic data about 3 IVL patients admitted to Chinese PLA General Hospital from January 2004 to November 2010 were retrospectively analyzed with related literature reviewed. Results Of the 3 patients,1 had menostaxis and hypermenorrhea,1 had a history of uterus leiomyoma enucleation with a pelvic mass found during follow-up after operation,and 1 had no clinical symptoms and signs.Ultrasound showed leiomyma in 2 patients before operation and malignant tumor could not be excluded in 1 patient.IVL was not definitely established.Three patients underwent a total hysterectomy during which diagnosis of IVL was established.Residual tumor was found in the right abdominal cavity of 1 patient 5 days after operation.The other 2 patients were followed up for 17 and 34 months,respectively,after operation,during which no recurrence of the tumor was found. Conclusion IVL is a benign lesion with biological features of malignant tumors.Its diagnostic rate is low after operation and its definite diagnosis depends mainly on pathologic examination.Surgical excision is the first choice of its treatment.IVL patients should be followed up for a long time after operation.