Li Jiezhen, Huang Haijian, Chen Xin, Zeng Qiang
Department of Pathology, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou, China.
Department of Pathology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Front Med (Lausanne). 2025 Apr 10;12:1534933. doi: 10.3389/fmed.2025.1534933. eCollection 2025.
To analyze the clinicopathological features and prognostic factors of intravenous Leiomyomatosis (IVL), a rare yet recurrent disease.
This retrospective observational study enrolled 43 patients with pathologically confirmed IVL. Clinicopathological data were collected and reviewed. Univariate analyses were performed to identify prognostic factors for IVL recurrence.
Clinical manifestations included increased menstrual flow (12/43), prolonged menstrual periods (18/43), pelvic mass (15/43), abdominal pain (8/43), or no symptoms (9/43). Histopathologically, tumor cells were predominantly located in the blood vessels of the uterine muscle wall and surrounding blood vessels. The tumor were composed of benign smooth muscle cells arranged in strips or bundles. Immunohistochemistry revealed that tumor cells were positive for SMA (43/43), Desmin (42/43), and Caldesmon (40/43). Incomplete resection of the lesions was identified as a risk factor for postoperative recurrence of IVL ( < 0.05). Age, menopause status, gravidity, parity, maximum diameter of IVL, uterine leiomyomas, involvement of uterine/extrauterine blood vessels, surgical methods, Ki-67 index, and mitotic figures were not associated with postoperative recurrence of IVL ( > 0.05).
IVL is a rare form of leiomyoma with potential for malignancy. Complete resection of the lesion should be performed whenever possible to improve patient prognosis.
分析静脉内平滑肌瘤病（IVL）这一罕见但易复发疾病的临床病理特征及预后因素。
本回顾性观察研究纳入43例经病理确诊的IVL患者。收集并回顾临床病理数据。进行单因素分析以确定IVL复发的预后因素。
临床表现包括月经量增多（12/43）、经期延长（18/43）、盆腔肿块（15/43）、腹痛（8/43）或无症状（9/43）。组织病理学上，肿瘤细胞主要位于子宫肌壁血管及周围血管内。肿瘤由呈条带状或束状排列的良性平滑肌细胞组成。免疫组化显示肿瘤细胞SMA（43/43）、结蛋白（42/43）和钙调蛋白（40/43）均呈阳性。病变切除不完全被确定为IVL术后复发的危险因素（<0.05）。年龄、绝经状态、妊娠次数、产次、IVL最大直径、子宫平滑肌瘤、子宫/子宫外血管受累情况、手术方式、Ki-67指数和核分裂象与IVL术后复发无关（>0.05）。
IVL是一种罕见的平滑肌瘤形式，有恶变潜能。应尽可能完整切除病变以改善患者预后。
