Intravenous Leiomyomatosis
Synonyms/Description
Benign metastasizing leiomyoma
Etiology
This is caused by intravascular proliferation of a smooth muscle, leiomyoma-like tumor, which is noninvading locally, but grows within venous channels of the uterus and pelvis as serpiginous tubular masses. This growth can be extensive and occasionally even reach the inferior vena cava and the right atrium, causing cardiac symptoms. In one study, 56% of patients with this condition had previously had a hysterectomy for uterine fibroids.
There are two possible etiologies for this rare tumor: (1) The tumor may originate from smooth muscle in the vessel wall itself. (2) The tumor originates from a uterine leiomyoma, subsequently invading adjacent venous channels.
Ultrasound Findings
These leiomyoma-like lesions are nodular, tubular, and serpiginous solid masses in the pelvis. The intravascular location of these masses is not well seen sonographically. Color flow is typically visible within these masses. The characteristic features are tubular solid masses, often bilateral, following the course of pelvic veins.
Differential Diagnosis
Pelvic malignancies separate from the uterus and ovaries, such as sarcoma or lymphoma.
Clinical Aspects and Recommendations
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