Surgical treatment for multiple uterine leiomyoma with intravascular leiomyomatosis

Background. Cases of intravascular leiomyomatosis are extremely rare, and the treatment of patients with this pathology is of particular interest in terms of surgical tactics. Description. The article describes a clinical case of successful surgical treatmentfor multiple uterine leiomyoma with intravenous and intracardiac leiomyomatosis. The patient was operated on urgently. Thrombus leiomyomectomy from the right atrium, right ventricle, all segments of the inferior vena cava and right iliac vein with hysterectomy without appendages was performed via total median sternolaparotomy in the presence of temporary occlusion of the vena cava and pulmonary artery. The postoperative period was uncomplicated. The patient was discharged from hospital in a satisfactory condition on the 14th day. Conclusion. The treatment could achieve not only the main goal of the operation to prevent massive pulmonary thromboembolism, but could also follow the ablastic principles of treatmentfor uterine leiomyomas.

leiomyomatosis, leiomyoma, uterus, inferior vena cava