A case of a rare internal intravenous leiomyomatosis was reviewed in the literature

Abstract Objectives: Intravenous leiomyomatosis invasion of the inferior vena cava is a rare disease, and there are no guidelines for the diagnosis and treatment of this disease. This study reported the diagnosis and treatment process of a case of intravenous leiomyomatosis invading the inferior vena cava, which provides clinical reference experience for the diagnosis and treatment of IVL. Methods: A 59-year-old woman, because of "physical examination found inferior vena cava thrombosis one month" admitted to hospital, 4 years before left ovarian+right fallopian tube+myomectomy, after admission line chest and abdominal enhanced CT prompt: inferior vena cava vein (renal vein level) filling defect, the following lumen and branches without visible, considering thrombus or tumor thrombus formation, the cervix left visible 1 about 8cm diameter fat density mass, enhanced scanning period is not strengthening. A multidisciplinary team performed laparotomy+resection of intravena cava tumor+total hysterectomy+right oophorectomy+repair of inferior vena cava and left iliac vein. Postoperative pathology suggested: spindle cell tumor, leiomyomatosis. Results: IVL is a special type of benign tumor in the mesoderm lobe.Surgical resection is the main mode of treatment. Conclusions: Intravenous vascular leiomyoma onset is insidious, lack of clinical manifestations of specificity, and easy to misdiagnosis and miss diagnosis. Accurate preoperative evaluation, multidisciplinary team cooperation, and appropriate surgical plan are the important factors for obtaining the best treatment results. The possibility of leiomyoma in the vein should be considered in female patients with uterine fibroids combined with pelvic compression, venous return dysfunction and right heart insufficiency.