Update on intravenous leiomyomatosis: report of five patients and literature review.

The objective of this study was to review management and results of surgical therapy of intravenous leiomyomatosis (IVL). A retrospective review of five patients treated at the Mayo Clinic between 2002 and 2012 and a literature review from 1970 to the present were performed. IVL is a rare condition, often overlooked, misdiagnosed or inadequately treated. Despite its benign histological features, invasion of large vessels and cardiac extension can occur and be fatal. Appropriate diagnosis and a radical surgical approach to IVL provide optimal outcomes. Incomplete resection and/or microscopic foci of IVL can lead to recurrence. Surgery should always aim for complete tumor excision and include hysterectomy and bilateral salpingoophorectomy. Radical parametrectomy and intravenous tumor resection may be necessary.