INTRAVENOUS LEIOMYOMATOSIS OF THE UTERUS - A CLINICOPATHOLOGICAL STUDY OF 22 CASES

Twenty-two cases of intravenous leiomyomatosis (IVL) of the uterus wer e examined at the Royal Women's Hospital, Melbourne, within a 22-year period. The mean age of the patients was 46 years (range, 23-66). Nine patients presented with a pelvic mass, nine with abnormal uterine ble eding, and one with prolapse of the uterus. In three cases, the presen ting features were unknown. Surgical exploration confirmed the presenc e of a uterine mass (mean size, 7.8 cm) which in seven cases extended into the broad ligament. In only 11 cases was involvement of the myome trial vessels obvious on gross examination. However, no extension into the iliac veins or inferior vena cava was found. In seven cases, the tumor involved to a minimal degree the immediately adjacent or contigu ous myometrial veins, and the diagnosis of IVL was made incidentally o n microscropic examination. Of the 16 patients with followup (mean, 7. 5 years) all are now disease free. Five years after the diagnosis of I VL, one patient (case 10) had a pulmonary smooth-muscle tumor resected . Ah 22 patients were treated by surgery alone, and to date none have died from disease. Our findings support the benign biologic behavior o f IVL even in the presence of metastases.