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Clinical Observation |

Intravenous Leiomyomatosis With Caval Involvement:  Report of a Case With Radical Resection and Venous Replacement

Pierre Bertrand, MD; Philippe Amabile, MD; Jean Hardwigsen, MD; Pierre Campan, MD; Y. Patrice Le Treut, MD
Arch Surg. 1998;133(4):460-462. doi:10.1001/archsurg.133.4.460.
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Intravenous leiomyomatosis is a rare, histologically benign neoplasm that may be malignant in its specific tendency to intravascular extension. A case of intravenous leiomyomatosis with extension into the entire inferior vena cava in a 41-year-old woman is described. The patient was diagnosed with syncope 3 years after hysterectomy and was treated with a 1-stage procedure including venous replacement.

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Figure 1.

Abdominopelvic computed tomographic scan. A, Right pelvic mass compressing the bladder. Note the path of the ureter between the 2 lobes of the lesion. B, At a lower abdominal level, the enlarged inferior vena cava lumen is occupied by a tissular formation. C, At the level of the retrohepatic inferior vena cava, the thrombus still occupies most of the lumen.

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Figure 2.

Inferior cavography. Homogeneous gap occupies all of the infrarenal portion of the inferior vena cava and a collateral circulation; the thinner suprarenal portion of the thrombus is not visible.

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Figure 3.

Schematic representation showing the continuity between pelvic lesion and inferior vena cava thrombus through the right hypogastric vein.

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