Noguera SMF, Ceja SJM, Villanueva RF, Tafoya RF, Mayoral SA

Language: Spanish
References: 8
Page: 483-486
PDF size: 260.40 Kb.

ABSTRACT

Diffuse uterine leiomyomatosis is a rare benign entity in gynecology, with only 30 worldwide reports. Its most frequent complications are dissemination into vena cava, cardiac obstruction (right cavities and valves), and diffuse pelvic invasion. We report a case of a 40 years old female with history of pelvic mass resection. During surgery it was found a large abdominal-pelvic mass diffusely invading uterine body, and round and infundibulum pelvic ligaments. This mass extends itself out of pelvis until aorto-abdominal bifurcation, and has gummatous, elastic, and highly bleeding consistency. Histopathologic report was intravenous leiomyomatosis with benign smooth muscular fibers infiltrating adjacent structures. Its origin was uterine tissue, but it invades, adjacently, all reproductive annexes deforming them anatomy. Its infiltrative quality confers a technical difficulty to surgeon, so he or she will need a multidisciplinary team to establish its treatment.

REFERENCES

1. Robles-Frias A, Severin CE, Robles-Frías MJ, Garrido JL. Diffuse uterine leiomyomatosis with ovarian and parametrial involvement. Obstet Gynecol 2001;97(5):834-5.

2. Bahary CM, Gorodeski IG, Nelly M, Avidor I, Garto IJ. Intravascular leiomyomatosis. Obstet Gynecol 1982;59(6): S73-S77.

3. Kaszar-Seibert DJ, Gauvin GP, Rogoff PA, Vittimberga FJ, et al. Intracardiac extension of intravenous leiomyomatosis. Radiology 1988;168:409-10.

4. Birch-Hirschfeld FV. Lehrbuch der pathologishe anatomie. 5th ed. Leipzing: FCW Vogel, 1897;pp:226-58.

5. Cea-Calvo L, Lozano F, Pombo M, Rodríguez E, et al. Images in cardiovascular medicine. Uterine intravenous leiomyomatosis extending through the inferior vena cava into the right cardiac cavities. Circulation 2000;101;581-3.

6. Ariza A, Cerra C, Hahn IS, Shaw RK, Rigney B. Intravascular leiomyomatosis of the uterus: a case report. Conn Med 1982;46:700-3.

7. Norris HJ, Parmley T. Mesenchymal tumors of the uterus. V. Intravenous leiomyomatosis: a clinical and pathologic study of 14 cases. Cancer 1975;36:2164-78.

8. Koh Dm, Burn PR, King DM. Benign metastasizing leiomyoma with intracaval leiomyomatosis. Br J Radiol 2000;73:435-7.