Intravascular leiomyomatosis: unusual variant of leiomyoma

Leiomyomas (fibroid) arise from the smooth muscle of the myometrium and are benign in nature. Intavascular leiomyomatosis is an unusual and rare condition where the fibroid grows into the pelvic veins and inferior vena cava and sometimes extends into the heart chambers. We present a case where a woman presented to us with multiple fibroids and underwent an abdominal hysterectomy. The diagnosis was not suspected before the surgery but diagnosed on histopathology. The patient underwent further surgery to remove the fibroids from the pelvic veins and the inferior vena cava. This condition has been reported in only few case reports around the world. In view of the rarity of this condition, the diagnosis can be easily missed. We suggest an increased vigilance in women who have large fibroids with unusual features in symptoms or during surgery. Pre-surgical imaging will help to make diagnosis, and good surgical outcomes can be achieved by a multidisciplinary surgical approach.