Uterine intravascular leiomyomatosis: an update and report of seven cases.

A clinicopathological study of seven cases of intravascular leiomyomatosis (IVL) was performed. The patients' ages ranged from 29 to 80 and all cases were associated with uterine leiomyomas. The intravascular extension involved preferentially uterine vessels, although the adnexa were also affected. Microscopically, the intravascular tumors resembled the primary leiomyomas. Mitotic count was low and never exceeded 3 per 10 high-power fields. Thick venous vessels, sometimes with thrombosis, were a conspicuous marker in intravascular locations. Necrosis and hemorrhage were found in four cases. Epithelioid IVL was found in one instance associated with a lipid cell tumor of the ovary. This series supports, for most cases, the notion of an origin from a preexisting leiomyoma. A review of treatment, prognosis, and histogenesis of IVL is performed.