Clinical analysis of 57 cases with intravenous leiomyomatosis
Objective To explore the clinical characteristics,treatment and prognosis of intravenous leiomyomatosis(IVL).Methods A retrospective analysis was conducted of the clinical data and follow-up of 57 patients with pathologically diagnosed IVL at the First Affiliated Hospital of Zhengzhou University from January 2013 to January 2023.Results The age of 57 patients was(45.2±5.5)years.1l patients(19.3％)had a history of myomectomy and 6 patients(10.5％)had a history of hysterectomy.The common symptoms:30 patients(52.6％)had increased menstrual volume or prolonged menstrual period,11 patients(19.3％)had abdominal distension,6 patients(10.5％)had palpitation or chest tightness,5 patients(8.8％)had lower limb edema.In this study,IVL was graded into four stages according to intravascular tumor progression.Stage Ⅰ:Tumor confined to the pelvic cavity in 33 cases;Stage Ⅱ:Tumor extended into the abdominal cavity in 16 cases;Stage Ⅲ:Tumor extended into the heart in 7 cases;Stage Ⅳ:Tumor extended the pulmonary artery in 1 case.All 57 patients underwent surgical treatment and were under strict follow-u[after surgery.During postoperative follow-up,3 patients showed evidence of recurrence,and one of them had reoperation.Conclusions IVL is a rare disease that usually occurs in reproductive and perimenopausal women with nonspecific manifestations.Surgey is the primary treatment.The surgical plan should be decided by the extent of tumor involvement.A regular postoperative follow-up is extremely essential.
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