Intravenous leiomyomatosis involving the uterus and ovaries
Malushko A.V., Scherbakova E.V., Alekseev S.M., Kovtun D.P., Polushin O.G., Bublikova A.A., Zenko O.E., Schedrina I.D.
Background: Leiomyoma is the most common benign monoclonal tumor of the uterus that originates from smooth muscle cells. The socalled borderline smooth muscle tumors of the uterus, neoplasms with uncertain clinical prognosis, are considered separately. These include intravenous leiomyomatosis (IVL), metastatic leiomyoma and leiomyomas of uncertain malignant potential.
Case report: The article presents a case of IVL in a 48-year-old woman with uterine and ovarian involvement. The disease manifested with non-specific gynecological symptoms. The examination revealed multiple uterine fibroids of large size. The patient underwent extirpation of the uterus with appendages in a conglomerate of myomatous nodes. After histological and immunohistochemical examination of the material obtained during the operation, IVL was diagnosed.
Conclusion: The unique aspect of this case is the combined damage to the uterus and ovaries, as well as the local progression of the pathological process, without the involvement of extra-organ veins. There is no code for borderline tumors involving the uterus and ovaries in the International Classification of Diseases, 10th Revision (ICD-10). According to the definitions of the international classification, this observation can be coded as D39.8, given that the subheading with the fourth character ‘.8’ indicates ‘lesions beyond one or more specified localizations’ in ICD-10 class II.
Authors’ contributions: Kovtun D.P., Malushko A.V., Alekseev S.M. – developing the concept and design of the study; Scherbakova E.V., Schedrina E.V., Bublikova A.A., Zenko O.E. – collecting and processing the material; Polushin O.G., Bublikova A.A., Zenko O.E. – review of publications on the subject of the article; Polushin O.G. – writing the text; Kovtun D.P., Malushko A.V., Alekseev S.M. – editing the article.
Conflicts of interest: Authors declare lack of the possible conflicts of interest.
Funding: The study was conducted without sponsorship.
Patient Consent for Publication: The patient signed informed consent for the publication of her data and associated images.
For citation: Malushko A.V., Scherbakova E.V., Alekseev S.M., Kovtun D.P., Polushin O.G., Bublikova A.A., Zenko O.E., Schedrina I.D. Intravenous leiomyomatosis involving the uterus and ovaries.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (4): 178-184 (in Russian)
https://dx.doi.org/10.18565/aig.2024.295
Keywords
uterus
leiomyoma
intravenous leiomyomatosis
case report
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Received 20.11.2024
Accepted 19.03.2025
About the Authors
Anton V. Malushko, Head of Gynecological Department, Leningrad Regional Clinical Hospital, 194291, Russia, St. Petersburg, Lunacharskogo Ave., 45, +7(812)670-18-88, a-malushko@mail.ru, https://orcid.org/0000-0002-4460-9075Ekaterina V. Shcherbakova, pathologist at the Central Pathological Department of General Pathology, Leningrad Region Bureau of Forensic Medicine,
194291, Russia, St. Petersburg, Santiago de Cuba str., 7, +7(495)536-92-70, maestrovody@mail.ru, https://orcid.org/0000-0002-3818-1535
Sergey M. Alekseev, PhD, Chief Physician, Leningrad Regional Clinical Hospital, 194291, Russia, St. Petersburg, Lunacharskogo Ave., 45, +7(812)670-18-88,
bmt312@gmail.com, https://orcid.org/0000-0003-1329-8689
Demyan P. Kovtun, PhD, Head of the Central Pathological Department of General Pathology, Leningrad Region Bureau of Forensic Medicine,
194291, Russia, St. Petersburg, Santiago de Cuba str., 7, +7(495)536-92-70, damian85@mail.ru, https://orcid.org/0000-0002-5526-1385
Oleg G. Polushin, PhD, pathologist at the Central Pathological Department of General Pathology, Leningrad Region Bureau of Forensic Medicine,
194291, Russia, St. Petersburg, Santiago de Cuba str., 7, +7(495)536-92-70, olegpolushin@yandex.ru, https://orcid.org/0000-0003-0366-3662
Anastasia A. Bublikova, pathologist at the Central Pathological Department of General Pathology, Leningrad Region Bureau of Forensic Medicine,
194291, Russia, St. Petersburg, Santiago de Cuba str., 7, +7(495)536-92-70, anastasiaselenteva1997@gmail.com, https://orcid.org/0009-0004-1046-8093
Oksana E. Zenko, pathologist at the Central Pathological Department of General Pathology, Leningrad Region Bureau of Forensic Medicine,
194291, Russia, St. Petersburg, Santiago de Cuba str., 7, +7(495)536-92-70, oksana.zolotilina.91@mail.ru, https://orcid.org/0009-0009-6267-0193
Irina D. Schedrina, PhD, doctor at Gynecological Department, Leningrad Regional Clinical Hospital, 194291, Russia, St. Petersburg, Lunacharskogo Ave., 45,
+7(812)670-18-88, forgottenz@mail.ru, https://orcid.org/0000-0003-0062-1256
Corresponding author: Ekaterina V. Shcherbakova, maestrovody@mail.ru
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