Intravascular Leiomyomatosis of the Uterus

intravascular leiomyomatosis

This patient underwent hysterectomy for "fibroids." However, when the gynecologist exposed the uterus, there were what appeared to be distended blood vessels extending from the lower uterine segment into the parametria. It was not technically feasible to resect the entire uterus, so a supracervical hysterectomy was performed.

On gross exam, the fundus was dominated by a 10-cm leiomyoma. However, most remarkable was the presence of numerous markedly distended blood vessels in the myometrium, containing firm rubbery tumors that were otherwise identical to the main tumor. In the photo above, the main tumor intrudes into the frame from above, while several markedly dilated veins distended with tumor are seen in the bottom half.

This photo was taken with a Nikon D-100 digital SLR fitted with a Sigma 50-mm macro lens set at f/8. The image was captured in RAW mode, but I later downsampled it considerably in the interest of minimizing file size.

Photograph by Ed Uthman, MD. Public domain. Posted 17 Jul 2005

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