Intravenous leiomyomatosis involving the uterus and ovaries

Мұқаба

Дәйексөз келтіру

Толық мәтін

Ашық рұқсат Ашық рұқсат
Рұқсат жабық Рұқсат берілді
Рұқсат жабық Рұқсат ақылы немесе тек жазылушылар үшін

Аннотация

Background: Leiomyoma is the most common benign monoclonal tumor of the uterus that originates from smooth muscle cells. The socalled borderline smooth muscle tumors of the uterus, neoplasms with uncertain clinical prognosis, are considered separately. These include intravenous leiomyomatosis (IVL), metastatic leiomyoma and leiomyomas of uncertain malignant potential.

Case report: The article presents a case of IVL in a 48-year-old woman with uterine and ovarian involvement. The disease manifested with non-specific gynecological symptoms. The examination revealed multiple uterine fibroids of large size. The patient underwent extirpation of the uterus with appendages in a conglomerate of myomatous nodes. After histological and immunohistochemical examination of the material obtained during the operation, IVL was diagnosed.

Conclusion: The unique aspect of this case is the combined damage to the uterus and ovaries, as well as the local progression of the pathological process, without the involvement of extra-organ veins. There is no code for borderline tumors involving the uterus and ovaries in the International Classification of Diseases, 10th Revision (ICD-10). According to the definitions of the international classification, this observation can be coded as D39.8, given that the subheading with the fourth character ‘.8’ indicates ‘lesions beyond one or more specified localizations’ in ICD-10 class II.

Негізгі сөздер

Толық мәтін

Рұқсат жабық

Авторлар туралы

Anton Malushko

Leningrad Regional Clinical Hospital

Email: a-malushko@mail.ru
ORCID iD: 0000-0002-4460-9075

obstetrician-gynecologist, Head of Gynecological Department

Ресей, 194291, St. Petersburg, Lunacharskogo Ave., 45

Ekaterina Shcherbakova

Bureau of Forensic Medical Expertise

Хат алмасуға жауапты Автор.
Email: maestrovody@mail.ru
ORCID iD: 0000-0002-3818-1535

pathologist at the Central Pathological Department of General Pathology

Ресей, 194291, St. Petersburg, Santiago de Cuba str., 7

Sergey Alekseev

Leningrad Regional Clinical Hospital

Email: bmt312@gmail.com
ORCID iD: 0000-0003-1329-8689

PhD, Chief Physician

Ресей, 194291, St. Petersburg, Lunacharskogo Ave., 45

Demyan Kovtun

Bureau of Forensic Medical Expertise

Email: damian85@mail.ru
ORCID iD: 0000-0002-5526-1385

PhD, Head of the Central Pathological Department of General Pathology

Ресей, 194291, St. Petersburg, Santiago de Cuba str., 7

Oleg Polushin

Bureau of Forensic Medical Expertise

Email: olegpolushin@yandex.ru
ORCID iD: 0000-0003-0366-3662

PhD, pathologist at the Central Pathological Department of General Pathology

Ресей, 194291, St. Petersburg, Santiago de Cuba str., 7

Anastasia Bublikova

Bureau of Forensic Medical Expertise

Email: anastasiaselenteva1997@gmail.com
ORCID iD: 0009-0004-1046-8093

pathologist at the Central Pathological Department of General Pathology

Ресей, 194291, St. Petersburg, Santiago de Cuba str., 7

Oksana Zenko

Bureau of Forensic Medical Expertise

Email: oksana.zolotilina.91@mail.ru
ORCID iD: 0009-0009-6267-0193

pathologist at the Central Pathological Department of General Pathology

Ресей, 194291, St. Petersburg, Santiago de Cuba str., 7

Irina Schedrina

Leningrad Regional Clinical Hospital

Email: forgottenz@mail.ru
ORCID iD: 0000-0003-0062-1256

PhD, doctor at Gynecological Department

Ресей, 194291, St. Petersburg, Lunacharskogo Ave., 45

Әдебиет тізімі

  1. Министерство здравоохранения Российской Федерации. Клинические рекомендации. Миома матки. М.; 2024. 23 с. [Ministry of Health of the Russian Federation. Clinical guidelines. Uterine myoma. Moscow; 2024. 23p. (in Russian)].
  2. Female genital tumours. WHO Classification of Tumours. 5th ed., Vol. 4. Lyon: IARC Press; 2020. 632 p.
  3. Паяниди Ю.Г., Жордания К.И., Стилиди И.С., Захарова Т.И., Бохян В.Ю. Гладкомышечные опухоли неясного злокачественного потенциала. Внутривенный лейомиоматоз (клиническое наблюдение). Акушерство и гинекология. 2014; 7: 89-92. [Payanidi Yu.G., Zhordania K.I., Stilidi I.S., Zakharova T.I., Bokhyan V.Yu. Smooth muscle tumors of uncertain malignant potential. Intravenous leiomyomatosis: A clinical case. Obstetrics and Gynegology. 2014; (7): 89-92. (in Russian)].
  4. Mulvany N.J., Slavin J.L., Ostör A.G., Fortune D.W. Intravenous leiomyomatosis of the uterus: A clinicopathologic study of 22 cases. Int. J. Gynecol. Pathol. 1994; 13(1): 1-9. https://dx.doi.org/10.1097/00004347-199401000-00001.
  5. Atik E., Altintaş S., Akansu B., Zeteroğlu S., Güngören A. Intravenous leiomyomatosis of uterus: A case report. Türk. Patoloji Dergisi. 2006; 22(2): 104-7.
  6. Ma G., Miao Q., Liu X., Zhang C., Lui J., Zheng Y. et al. Different surgical strategies of patients with intravenous leiomyomatosis. Medicine (Baltimore). 2016; 95(37): e4902. https://dx.doi.org/10.1097/MD.0000000000004902.
  7. Ядренцева С.В., Нуднов Н.В. Метастазирующий интравенозный лейомиоматоз. Медицинская визуализация. 2018; 22(2): 117-26. [Yadrentseva S.V., Nudnov N.V. Metastatic intravenous leiomyomatosis. Medical Visualization. 2018; 22(2): 117-26. (in Russian)]. https://dx.doi.org/10.24835/1607-0763-2018-2-117-126.
  8. Леваков С.А. Диагностика простой и пролиферирующей миомы матки. Вестник новых медицинских технологий. 2000; 7(2): 82-6. [Levakov S.A. Diagnosis of simple and proliferating uterine fibroids. Journal of New Medical Technologies. 2000; 7(2): 82-6. (in Russian)].
  9. Леваков С.А., Зайратьянц О.В., Мовтаева Х.Р. Миома матки. Учебное пособие. М.: Группа МДВ; 2019. 168 с. [Levakov S.A., Zayratyants O.V., Movtayeva Kh.R. Uterine fibroids. Textbook. Moscow: MDV Group; 2019. 168 p. (in Russian)].
  10. Сидорова И.С., Агеев М.Б. Клинико-морфологические особенности простой и пролиферирующей миомы матки. Российский вестник акушера-гинеколога. 2013; 13(6): 34-8. [Sidorova I.S., Ageev M.B. The clinical and morphological features of simple and proliferating uterine myoma. Russian Bulletin of Obstetrician-Gynecologist. 2013; 13(6): 34-8. (in Russian)].
  11. Chen J., Bu H., Zhang Z., Chu R., Qi G., Zhao C. et al. Clinical features and prognostic factors analysis of intravenous leiomyomatosis. Front. Surg. 2023; 9: 1020004. https://dx.doi.org/10.3389/fsurg.2022.1020004.
  12. Lim W.H., Lamaro V.P., Sivagnanam V. Manifestation and management of intravenous leiomyomatosis: A systematic review of the literature. Surg. Oncol. 2022; 45: 101879. https://dx.doi.org/10.1016/j.suronc.2022.101879.
  13. Парамонова Т.И., Вдовкин А.В., Палькова В.А., Горностаева О.С. Комплексная лучевая диагностика внутривенного лейомиоматоза с экспансивным ростом в просвет нижней полой вены, полость правого предсердия и правого желудочка (клиническое наблюдение). Диагностическая и интервенционная радиология. 2012; 6(1): 105-12. [Paramonova T.I., Vdovkin A.V., Palkova V.A., Gornostayeva O.S. Complex X-ray diagnosis of intravenous leiomyomatosis with expansive growth into the lumen of the inferior vena cava, the cavity of the right atrium and the right ventricle (Case report). Diagnostic and Interventional Radiology. 2012; 6(1): 105-12. (in Russian)].
  14. Стилиди И.С., Чарчян Э.Р., Жордания К.И., Бохян В.Ю., Козлов Н.А., Паяниди Ю.Г. Интракардиальный внутривенный лейомиоматоз. Описание клинического случая. Клиническая и экспериментальная хирургия. 2021; 9(1): 70-6. [Stilidi I.S., Charchyan E.R., Zhordania K.I., Bokhian V.Ju., Kozlov N.A., Pajanidi J.G. Intracardiac intravenous leiomyomatosis: description of a clinical case. Clinical and Experimental Surgery. 2021; 9(1): 70-6. (in Russian)]. https://dx.doi.org/10.33029/ 2308-1198-2021-9-1-70-76.
  15. Давыдов М.И., Давыдов М.М., Чарчян Э.Р., Герасимов С.С., Скворцов А.А., Левченко Н.Е., Кулик И.О., Локшин Л.С. Современные возможности хирургического лечения больных внутривенным лейомиоматозом с опухолевым тромбозом правых отделов сердца в условиях веноартериальной перфузии с мембранной оксигенацией. Кардиология и сердечно-сосудистая хирургия. 2017; 10(5): 81-8. [Davydov M.I., Davydov M.M., Charchyan E.R., Gerasimov S.S., Skvortsov A.A., Levchenko N.E., Kulik I.O., Lokshin L.S. Modern possibilities of surgical treatment of patients with intravenous leiomyomatosis and tumoral thrombosis of right cardiac chambers by using of venoarterial perfusion with membrane oxygenation. Russian Journal of Cardiology and Cardiovascular Surgery. 2017; 10(5): 81-8. (in Russian)]. https://dx.doi.org/10.17116/kardio201710581-88.
  16. Radswiki T., Knipe H., Leong Y. et al. Intravenous leiomyomatosis. Reference article, Radiopaedia.org (Article created: 1 Mar 2011, Last revised: 30 Nov 2022). https://dx.doi.org/10.53347/rID-13103.
  17. Steiner P.E. Metastasizing fibroleiomyoma of the uterus: Report of a case and review of the literature. Am. J. Pathol. 1939; 15(1): 89-110.
  18. Prasad I., Sinha S., Sinha U., Kumar T., Singh J. Diffuse leiomyomatosis of the uterus: A diagnostic enigma. Cureus. 2022; 14(9): e29595. https:// dx.doi.org/10.7759/cureus.29595.
  19. Birch-Hirschfeld F.V. Lehrbuch der pathologischen аnatomie, 5th ed. Leipzig: Verlag Von F.C.W.Vogel; 1894. 1130 p.
  20. Андреева Ю.Ю., Франк Г.А., Шикеева А.А., Москвина Л.В., Кекеева Т.В. Завалишина Л.Э., Новикова Е.Г., Пронин С.М., Костин А.Ю. Внутрисосудистый лейомиоматоз. Архив патологии. 2015; 77(3): 51-6. [Andreeva Yu.Yu., Frank G.A., Shikeeva A.A., Moskvina L.V., Kekeeva T.V. Zavalishina L.E., Novikova E.G., Pronin S.M., Kostin A.Yu. Intravascular leiomyomatosis. Russian Journal of Archive of Pathology. 2015; 77(3): 51-6. (in Russian)]. https://dx.doi.org/10.17116/patol201577351-56.
  21. Давыдов М.М., Филатов А.А., Глухов Е.В., Чеишвили З.М., Груздев В.Е., Фомина Е.А. Хирургическое лечение внутривенного лейомиоматоза с интракардиальным распространением в условиях искусственного кровообращения. Клинический случай. MD-Onco. 2024; 4(1): 58-62. [Davydov M.M., Filatov A.A., Glukhov E.V., Cheishvilli Z.M., Gruzdev V.E., Fomina E.A. Surgical treatment of intravenous leiomyomatosis with intracardial growth in conditions of artificial circulation. Clinical case. MD-Onco. 2024; 4(1): 58-62. (in Russian)]. https://dx.doi.org/10.17650/ 2782-3202-2024-4-1-58-62.
  22. Кулик И.О., Левченко Н.Е., Герасимов С.С., Захарова Т.И., Бяхова В.А., Смирнова Г.Ф., Паяниди Ю.Г., Давыдов М.М. Внутривенный лейомиоматоз с интракардиальным распространением (клиническое наблюдение). Онкогинекология. 2017; 23(3): 43-50. [Kulik I.O., Levchenko N.E., Gerasimov S.S., Zakharova T.I., Byakhova V.A., Smirnova G.F., Pajanidi J.G., Davydov M.M. Intravenous leiomyomatosis with intracardiac extension (clinical observation). Oncogynecology. 2017; 23(3): 43-50. (in Russian)].
  23. Андреева Ю.Ю., Данилова Н.В., Шикеева А.А., Кекеева Т.В., Завалишина Л.Э., Франк Г.А. Доброкачественная метастазирующая лейомиома тела матки. Архив патологии. 2012; 74(6): 39-43. [Andreeva Yu.Yu., Danilova N.V., Shikeyeva A.A., Kekeyeva T.V., Zavalishina L.E., Frank G.A. Benign metastatic leiomyoma of the corpus uteri. Russian Journal of Archive of Pathology. 2012; 74(6): 39-43. (in Russian)].
  24. Yu X., Fu J., Cao T., Huang L., Qie M., Ouyang Y. Clinicopathologic features and clinical outcomes of intravenous leiomyomatosis of the uterus: A case series. Medicine (Baltimore). 2021; 100(1): e24228. https://dx.doi.org/10.1097/MD.0000000000024228.
  25. Шеберова Е.В., Рябов А.Б., Агабабян Т.А., Гриневич В.Н., Афонин Г.В., Колобаев И.В., Цыгельников С.А., Терских Д.С., Минаева Н.Г., Иванов С.А., Каприн А.Д. Лучевые методы в диагностике интравенозного лейомиоматоза: описание клинического случая и обзор литературы. Клинический разбор в общей медицине. 2024; 5(7): 52-8. [Sheberova E.V., Ryabov A.B., Agababian T.A., Grinevich V.N., Afonin G.V., Kolobaev I.V., Tsygelnikov S.A., Terskih D.S., Minaeva N.G., Ivanov S.A., Kaprin A.D. Imaging of intravenous leiomyomatosis: a case report and literature review. Clinical review for general practice. 2024; 5(7): 52-8. (in Russian)]. https://dx.doi.org/10.47407/kr2024.5.7.00p426..
  26. Gong Q., Xue N. Imaging findings of a case report of intravenous lipoleiomy-omatosis. AME Case Rep. 2024; 8: 77. https://dx.doi.org/10.21037/acr-24-21.
  27. Леваков С.А., Кавиладзе М.Г., Гусейнова Ш.Т. Миома матки: требует ли нынешняя парадигма лечения модернизации? Акушерство и гинекология. 2024; 3: 35-48. [Levakov S.A., Kaviladze M.G., Guseynova Sh.T. Uterine fibroids: does the current paradigm of treatment require modernization? Obstetrics and Gynegology. 2024; (3): 35-48. (in Russian)]. https:// dx.doi.org/10.18565/aig.2023.308.

Қосымша файлдар

Қосымша файлдар
Әрекет
1. JATS XML
Жүктеу
2. Fig. 1. Ultrasound of the pelvic organs: A - endometrium; B - left ovary

Жүктеу (265KB)
Метадеректер
3. Fig. 2. Morphology of intravascular tumor growth: A, B - intravascular tumor growth; B-D - expression of caldesmon (B), estrogen receptors (G) and progesterone (D). A - hematoxylin and eosin staining, ×50; B - Masson staining, ×50; B-D - immunohistochemistry, ×400

Жүктеу (1MB)
Метадеректер

© Bionika Media, 2025