Cardiovascular Ultrasonographic Features and Clinical Findings for Intravenous Leiomyomatosis: A Case Report

To summarize the vascular ultrasonographic features of intravenous leiomyomatosis (IVL) and assess the role of this method for the accurate diagnosis of patients with IVL. The current study was carried out in Shandong provincial hospital affiliated to Shandong university and Shandong medical imaging research institute, Shandong university of Jinan, Shandong province, P.R. China in 2017.
The 9 samples of IVL were collected from patients undergone surgery from July 2007 to December 2016 in the department of gynecology of the hospital. The clinical data, vascular ultrasonographic findings, and histologic results were retrospectively reviewed. Six patients underwent computed tomography (CT) and 3 patients were examined by magnetic resonance imaging (MRI). Clinical symptoms included lower extremity edema, chest congestion, and syncope. Any pelvic masses found were identified. On ultrasonography, the internal iliac vein, common iliac vein, and the inferior vena cava (IVC) were all involved with dilated veins and isoechoic masses noted in all 9 patients. The right ovarian vein was involved in 2 patients, and in 3 patients, masses had emerged in the IVC and spread into the right atrium, at times intruding into the tricuspid orifice during diastole. All 9 patients underwent a 1-stage thoracoabdominal surgical procedure. There was no documented recurrence of the masses in 7 patients and in the remaining 2 patients; solid pelvic masses were detected 3 or 6 months after the surgery. No intravascular masses were detected.
Ultrasonography is performed to evaluate the features and path of extension of IVL. Patients diagnosed with uterine leiomyoma or hysterectomy were at greater risk of developing IVL. Vascular ultrasound could be used as an additional diagnostic tool for IVL screening and diagnosis in patients at an early age.