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目的探讨子宫静脉内平滑肌瘤病(IVL)的临床特征和处理方法,提高对该病的认识。方法对已确诊的3例子宫静脉内平滑肌瘤病患者的临床资料进行回顾分析,并复习相关文献。结果子宫IVL患者与子宫肌瘤的临床表现相同,表现为经量增多、经期延长、盆腹腔包块。术前无特异性的诊断方法,术中发现肌壁间静脉内可见蜂窝状、蠕虫状结节,延伸至宫壁。宫旁静脉增粗,静脉内可见索条状组织,质韧如橡皮样。病理检查是确诊的依据。本病典型病理改变为静脉内见蠕虫样、条索状瘤体,可抽出,镜下呈良性平滑肌瘤的形态,不侵袭静脉壁。结论子宫IVL是具有恶性生物学行为的良性疾病,术前诊断率极低,术中能否正确诊断、处理关系到患者预后,需注重术中探查,提高术中确诊率。
Objective To investigate the clinical features and treatment of uterine venous leiomyomatosis (IVL) and to improve the understanding of the disease. Methods The clinical data of 3 cases of diagnosed uterine venous leiomyomata were retrospectively analyzed and relevant literatures were reviewed. Results The clinical manifestations of uterine fibroids in IVL patients were the same as those of patients with uterine fibroids. No specific preoperative diagnosis, intraoperative intramural venous found in honeycomb, worm-like nodules, extending to the uterine wall. Paraventricular thickening of the vein, the vein visible cord-like tissue, tough as rubber-like quality. Pathological examination is the basis for diagnosis. Typical pathological changes of this disease to see the worm-like intravenous, cord-like tumor, can be extracted, microscopic appearance of benign leiomyoma, does not affect the vein wall. Conclusions Uterine IVL is a benign disease with malignant biological behavior. The preoperative diagnosis rate is very low. Whether intraoperative diagnosis is correct or not depends on intraoperative exploration and the rate of intraoperative diagnosis.