下腔静脉内平滑肌瘤病诊治分析

目的 总结下腔静脉内平滑肌瘤病的诊治经验.方法 回顾性分析1998年3月至2007年4月收治的8例下腔静脉内平滑肌瘤病患者的临床资料,并随访观察其疗效.结果 8例患者中4例术前经下腔静脉造影同时取活检术前诊断为下腔静脉内平滑肌瘤病.8例患者中有1例拒绝手术治疗,14个月后猝死.接受手术治疗的7例患者术后病理示IVL,其中除1例死于术中大出血,1例术后2年复发外,其余5例无严重并发症,术后随访7～65个月,平均随访29个月,已恢复正常生活.结论 下腔静脉内平滑肌瘤病多源于子宫平滑肌瘤,是一种雌激素依赖性肿瘤.下腔静脉造影的同时取活组织检查是术前诊断下腔静脉内平滑肌瘤病的有效方法.手术切除肿瘤是惟一有效的治疗方法,同时应进行抗雌激素治疗,近期疗效满意.

Intravenous leiomyomatosis of the inferior vena cava

Objective To summarize the experience on the diagnosis and therapy of intravenous leiomyomatosis(IVL)of the inferior vena cava.Methods Eight IVL patients were treated in our hospital from March 1998 to April 2007. Results The diagnosis of IVL of the inferior vena cava was established histologically by biopsy during inferior vena eavagram before operation in 4 patients.Seven patients received open surgery.Except one patient dying of massive hemorrhage during operation and one IVL recurrence during follow-up,postoperative course was uneventful and an average follow-up of 29 months found no recurrence in the other five patients. Conclusion The final diagnosis of IVL of the inferior vena cava depends on venogram and biopsy,and it is an estrogen dependent tumor originating from uterus leiomyoma.Total surgical extirpation of the tumor is the only effective treatment for IVL.