子宫静脉内平滑肌瘤病3例及文献复习

Intravenous Leiomyomatosis of the Uterus: A Report of 3 Cases and Review of the Literatures

目的:探讨子宫静脉内平滑肌瘤病(IVL)的临床特征和诊治要点。方法:对接受手术治疗的3例IVL患者的临床和病理资料进行分析,并对相关文献进行复习。结果:3例患者因子宫肌瘤接受全子宫切除手术,术前均未明确诊断出IVL,其中1例在术中偶然发现子宫静脉内瘤栓并将其完整取出,另2例术后病理检查时才发现微小瘤栓,瘤栓组织形态符合良性平滑肌瘤。3例测定雌激素受体,其中2例阳性。3例术后均未经特殊治疗,随诊8～32个月,无异常情况。结论:IVL容易被临床忽视,应注重术前检查及术中探查,根治IVL依靠彻底性手术。

Objective： To study the clinical characteristics, diagnosis and treatment of intravenous leiomyomatosis （IVL） of the uterus. Methods： The clinical and pathological data of 3 cases with IVL was studied, and related literatures were reviewed. Results： No IVL was diagnosed before total abdominal hysterectomy were performed in all 3 cases. In one case, wormlike tumor was found in the right uterine vein by accident, and it was easily removed during operation. In the other two cases, intravenous tumors were found only by the gross examination and confirmed to be benign smooth muscle tumor. Positive estrogen receptors were detected in two cases. After 8 to 32 month＇s follow-up, no recurrence was found. Conclusions： IVL is always overlooked, so it is quite important to pay more attention to preoperative examination and intraoperative exploration. The choice of the treatment for this disease is the total resection. A long-term follow-up is recommended since the disease demonstrates a tendency to recur.