Aberrant uterine leiomyomas with extrauterine manifestation: intravenous leiomyomatosis and benign metastasizing leiomyomas
ObjectiveIntravenous leiomyomatosis (IVL) and benign metastasizing leiomyoma (BML) are uncommon variants of benign uterine leiomyomas with extrauterine manifestations. Categorizing the extent of disease allows clinicians to delineate the clinical spectrum and the level of sophistication for complete...
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| Format: | Article |
| Language: | English |
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Korean Society of Obstetrics and Gynecology
2018-07-01
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| Series: | Obstetrics & Gynecology Science |
| Subjects: | |
| Online Access: | http://ogscience.org/upload/pdf/ogs-61-509.pdf |
| _version_ | 1828767323889074176 |
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| author | Yoo-Na Kim Kyung Jin Eoh Jung-Yun Lee Eun Ji Nam Sunghoon Kim Sang Wun Kim Young Tae Kim |
| author_facet | Yoo-Na Kim Kyung Jin Eoh Jung-Yun Lee Eun Ji Nam Sunghoon Kim Sang Wun Kim Young Tae Kim |
| author_sort | Yoo-Na Kim |
| collection | DOAJ |
| description | ObjectiveIntravenous leiomyomatosis (IVL) and benign metastasizing leiomyoma (BML) are uncommon variants of benign uterine leiomyomas with extrauterine manifestations. Categorizing the extent of disease allows clinicians to delineate the clinical spectrum and the level of sophistication for complete surgical resection.MethodsTwelve patients with IVL and BML were reviewed. They were divided into early versus late stage disease groups, and initial manifestation, clinical characteristics, laboratory values, surgical pathology, and follow up data were summarized.ResultsPatients were mostly pre- or peri-menopausal and parous. Patients with late stage disease were more likely to present with cardiac symptoms or abnormal findings on chest X-ray, whereas those with early stage disease presented with classical leiomyoma symptoms including heavy menstrual bleeding, increased myoma size, or lower abdominal discomfort. Tumor marker levels were within normal ranges. A trend of higher neutrophil to leukocyte ratio was observed in the late versus the early stage group (10.4 vs. 1.51, P=0.07); the platelet leukocyte ratio was statistically higher in patients with late stage IVL (0.23 vs. 0.13, P=0.04). The overall recurrence rate was 25%. No recurrence was observed in stage I or stage III IVL groups, while 50% of the stage II IVL group showed recurrence in the pelvic cavity.ConclusionIVL and BML are benign myoma variants with paradoxically metastatic clinical presentation. Careful inquiry of systemic symptoms, the presence of underlying systemic inflammation, and a high index of suspicion are required for preoperative diagnosis. Furthermore, a multidisciplinary approach is necessary to improve outcomes of surgical resection. |
| first_indexed | 2024-12-11T07:25:01Z |
| format | Article |
| id | doaj.art-027a84bd92e141ce903267eab460759a |
| institution | Directory Open Access Journal |
| issn | 2287-8572 2287-8580 |
| language | English |
| last_indexed | 2024-12-11T07:25:01Z |
| publishDate | 2018-07-01 |
| publisher | Korean Society of Obstetrics and Gynecology |
| record_format | Article |
| series | Obstetrics & Gynecology Science |
| spelling | doaj.art-027a84bd92e141ce903267eab460759a2022-12-22T01:15:59ZengKorean Society of Obstetrics and GynecologyObstetrics & Gynecology Science2287-85722287-85802018-07-0161450951910.5468/ogs.2018.61.4.509515Aberrant uterine leiomyomas with extrauterine manifestation: intravenous leiomyomatosis and benign metastasizing leiomyomasYoo-Na Kim0Kyung Jin Eoh1Jung-Yun Lee2Eun Ji Nam3Sunghoon Kim4Sang Wun Kim5Young Tae Kim6Department of Obstetrics and Gynecology, Institute of Women's Medical Life Science, Yonsei University College of Medicine, Seoul, .KoreaDepartment of Obstetrics and Gynecology, Institute of Women's Medical Life Science, Yonsei University College of Medicine, Seoul, .KoreaDepartment of Obstetrics and Gynecology, Institute of Women's Medical Life Science, Yonsei University College of Medicine, Seoul, .KoreaDepartment of Obstetrics and Gynecology, Institute of Women's Medical Life Science, Yonsei University College of Medicine, Seoul, .KoreaDepartment of Obstetrics and Gynecology, Institute of Women's Medical Life Science, Yonsei University College of Medicine, Seoul, .KoreaDepartment of Obstetrics and Gynecology, Institute of Women's Medical Life Science, Yonsei University College of Medicine, Seoul, .KoreaDepartment of Obstetrics and Gynecology, Institute of Women's Medical Life Science, Yonsei University College of Medicine, Seoul, .KoreaObjectiveIntravenous leiomyomatosis (IVL) and benign metastasizing leiomyoma (BML) are uncommon variants of benign uterine leiomyomas with extrauterine manifestations. Categorizing the extent of disease allows clinicians to delineate the clinical spectrum and the level of sophistication for complete surgical resection.MethodsTwelve patients with IVL and BML were reviewed. They were divided into early versus late stage disease groups, and initial manifestation, clinical characteristics, laboratory values, surgical pathology, and follow up data were summarized.ResultsPatients were mostly pre- or peri-menopausal and parous. Patients with late stage disease were more likely to present with cardiac symptoms or abnormal findings on chest X-ray, whereas those with early stage disease presented with classical leiomyoma symptoms including heavy menstrual bleeding, increased myoma size, or lower abdominal discomfort. Tumor marker levels were within normal ranges. A trend of higher neutrophil to leukocyte ratio was observed in the late versus the early stage group (10.4 vs. 1.51, P=0.07); the platelet leukocyte ratio was statistically higher in patients with late stage IVL (0.23 vs. 0.13, P=0.04). The overall recurrence rate was 25%. No recurrence was observed in stage I or stage III IVL groups, while 50% of the stage II IVL group showed recurrence in the pelvic cavity.ConclusionIVL and BML are benign myoma variants with paradoxically metastatic clinical presentation. Careful inquiry of systemic symptoms, the presence of underlying systemic inflammation, and a high index of suspicion are required for preoperative diagnosis. Furthermore, a multidisciplinary approach is necessary to improve outcomes of surgical resection.http://ogscience.org/upload/pdf/ogs-61-509.pdfleiomyoma, uterinesmooth muscle tumorleiomyomatosisneoplasm metastasis |
| spellingShingle | Yoo-Na Kim Kyung Jin Eoh Jung-Yun Lee Eun Ji Nam Sunghoon Kim Sang Wun Kim Young Tae Kim Aberrant uterine leiomyomas with extrauterine manifestation: intravenous leiomyomatosis and benign metastasizing leiomyomas Obstetrics & Gynecology Science leiomyoma, uterine smooth muscle tumor leiomyomatosis neoplasm metastasis |
| title | Aberrant uterine leiomyomas with extrauterine manifestation: intravenous leiomyomatosis and benign metastasizing leiomyomas |
| title_full | Aberrant uterine leiomyomas with extrauterine manifestation: intravenous leiomyomatosis and benign metastasizing leiomyomas |
| title_fullStr | Aberrant uterine leiomyomas with extrauterine manifestation: intravenous leiomyomatosis and benign metastasizing leiomyomas |
| title_full_unstemmed | Aberrant uterine leiomyomas with extrauterine manifestation: intravenous leiomyomatosis and benign metastasizing leiomyomas |
| title_short | Aberrant uterine leiomyomas with extrauterine manifestation: intravenous leiomyomatosis and benign metastasizing leiomyomas |
| title_sort | aberrant uterine leiomyomas with extrauterine manifestation intravenous leiomyomatosis and benign metastasizing leiomyomas |
| topic | leiomyoma, uterine smooth muscle tumor leiomyomatosis neoplasm metastasis |
| url | http://ogscience.org/upload/pdf/ogs-61-509.pdf |
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