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Intravascular leiomyomatosis: a continuing diagnostic challenge
  1. Emil Magnus Mong Kolstad1,
  2. Signe Østergård1,
  3. Gratien Andersen2 and
  4. Katrine Fuglsang1
  1. 1Gynecology and Obstetrics, Aarhus Universitetshospital Skejby, Aarhus, Denmark
  2. 2Radiology, Aarhus Universitetshospital Skejby, Aarhus, Denmark
  1. Correspondence to Dr Katrine Fuglsang; katrfugl{at}


We report the case of a woman in her 60s with intravascular leiomyomatosis. She suffered from numerous non-specific symptoms including weight loss, anaemia and sudden swelling of the left lower extremity. CT imaging showed the presence of an enlarged left ovary and a thrombus extending from the left ovarian venous plexus intruding into the right atrium of the heart. Cancer antigen 125 was 20 U/mL. Pelvic transvaginal ultrasound examination identified two normal ovaries and a mass adjacent to the left ovary. A second opinion on the CT scan was requested at a oncogynaecological multidisciplinary team meeting, where the radiologist of the team identified an intervascular leiomyomatosis. After further investigation, surgical treatment was planned and completed in collaboration with the departments of cardiothoracic and vascular surgery. The patient recovered fully.

  • Obstetrics and gynaecology
  • Gynecological cancer
  • Cardiothoracic surgery
  • Vascular surgery
  • Surgical oncology

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  • Contributors In preparation of the case report, the following contributions were made: EMMK, SØ and KF contributed to the case reports conception and design. EMMK and KF planned the work process of the project. SØ prepared parts of the manuscripts first draft. EMMK wrote and prepared the main manuscript. EMMK, SØ and KF contributed to acquisition of data and relevant information. EMMK and KF analysed and interpretated all information and data in relation to the case report. EMMK and KF were responsible for correction and editing of the manuscript. EMMK and GA were responsible for the preparation and interpretation of the radiology images and image legends. GA provided the radiology images. EMMK made all graphical designs. EMMK and KF contributed to preparation and interpretation of the surgical and specimen images and image legends. All authors contributed to the manuscript and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.