Treatment of Intravenous Leiomyomatosis with Cardiac Extension following Incomplete Resection

Aim. Intravenous leiomyomatosis (IVL) with cardiac extension (CE) is a rare variant of benign uterine leiomyoma. Incomplete resection has a recurrence rate of over 30%. Different hormonal treatments have been described following incomplete resection; however no standard therapy currently exists. We...

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Main Authors: Mathew P. Doyle, Annette Li, Claudia I. Villanueva, Sheen C. S. Peeceeyen, Michael G. Cooper, Kevin C. Hanel, Gary G. Fermanis, Greg Robertson
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:International Journal of Vascular Medicine
Online Access:http://dx.doi.org/10.1155/2015/756141
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author Mathew P. Doyle
Annette Li
Claudia I. Villanueva
Sheen C. S. Peeceeyen
Michael G. Cooper
Kevin C. Hanel
Gary G. Fermanis
Greg Robertson
author_facet Mathew P. Doyle
Annette Li
Claudia I. Villanueva
Sheen C. S. Peeceeyen
Michael G. Cooper
Kevin C. Hanel
Gary G. Fermanis
Greg Robertson
author_sort Mathew P. Doyle
collection DOAJ
description Aim. Intravenous leiomyomatosis (IVL) with cardiac extension (CE) is a rare variant of benign uterine leiomyoma. Incomplete resection has a recurrence rate of over 30%. Different hormonal treatments have been described following incomplete resection; however no standard therapy currently exists. We review the literature for medical treatments options following incomplete resection of IVL with CE. Methods. Electronic databases were searched for all studies reporting IVL with CE. These studies were then searched for reports of patients with inoperable or incomplete resection and any further medical treatments. Our database was searched for patients with medical therapy following incomplete resection of IVL with CE and their results were included. Results. All studies were either case reports or case series. Five literature reviews confirm that surgery is the only treatment to achieve cure. The uses of progesterone, estrogen modulation, gonadotropin-releasing hormone antagonism, and aromatase inhibition have been described following incomplete resection. Currently no studies have reviewed the outcomes of these treatments. Conclusions. Complete surgical resection is the only means of cure for IVL with CE, while multiple hormonal therapies have been used with varying results following incomplete resection. Aromatase inhibitors are the only reported treatment to prevent tumor progression or recurrence in patients with incompletely resected IVL with CE.
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spelling doaj-art-7c1929db19cf4b239f3d92cc0a1f8b1d2025-08-20T02:06:54ZengWileyInternational Journal of Vascular Medicine2090-28242090-28322015-01-01201510.1155/2015/756141756141Treatment of Intravenous Leiomyomatosis with Cardiac Extension following Incomplete ResectionMathew P. Doyle0Annette Li1Claudia I. Villanueva2Sheen C. S. Peeceeyen3Michael G. Cooper4Kevin C. Hanel5Gary G. Fermanis6Greg Robertson7Department of Cardiothoracic Surgery, St George Hospital, Sydney, NSW 2217, AustraliaDepartment of Cardiothoracic Surgery, St George Hospital, Sydney, NSW 2217, AustraliaDepartment of Cardiothoracic Surgery, St George Hospital, Sydney, NSW 2217, AustraliaDepartment of Cardiothoracic Surgery, St George Hospital, Sydney, NSW 2217, AustraliaDepartment of Anesthesia, St George Hospital, Sydney, NSW 2217, AustraliaUniversity of New South Wales, Sydney, NSW 2000, AustraliaDepartment of Cardiothoracic Surgery, St George Hospital, Sydney, NSW 2217, AustraliaUniversity of New South Wales, Sydney, NSW 2000, AustraliaAim. Intravenous leiomyomatosis (IVL) with cardiac extension (CE) is a rare variant of benign uterine leiomyoma. Incomplete resection has a recurrence rate of over 30%. Different hormonal treatments have been described following incomplete resection; however no standard therapy currently exists. We review the literature for medical treatments options following incomplete resection of IVL with CE. Methods. Electronic databases were searched for all studies reporting IVL with CE. These studies were then searched for reports of patients with inoperable or incomplete resection and any further medical treatments. Our database was searched for patients with medical therapy following incomplete resection of IVL with CE and their results were included. Results. All studies were either case reports or case series. Five literature reviews confirm that surgery is the only treatment to achieve cure. The uses of progesterone, estrogen modulation, gonadotropin-releasing hormone antagonism, and aromatase inhibition have been described following incomplete resection. Currently no studies have reviewed the outcomes of these treatments. Conclusions. Complete surgical resection is the only means of cure for IVL with CE, while multiple hormonal therapies have been used with varying results following incomplete resection. Aromatase inhibitors are the only reported treatment to prevent tumor progression or recurrence in patients with incompletely resected IVL with CE.http://dx.doi.org/10.1155/2015/756141
spellingShingle Mathew P. Doyle
Annette Li
Claudia I. Villanueva
Sheen C. S. Peeceeyen
Michael G. Cooper
Kevin C. Hanel
Gary G. Fermanis
Greg Robertson
Treatment of Intravenous Leiomyomatosis with Cardiac Extension following Incomplete Resection
International Journal of Vascular Medicine
title Treatment of Intravenous Leiomyomatosis with Cardiac Extension following Incomplete Resection
title_full Treatment of Intravenous Leiomyomatosis with Cardiac Extension following Incomplete Resection
title_fullStr Treatment of Intravenous Leiomyomatosis with Cardiac Extension following Incomplete Resection
title_full_unstemmed Treatment of Intravenous Leiomyomatosis with Cardiac Extension following Incomplete Resection
title_short Treatment of Intravenous Leiomyomatosis with Cardiac Extension following Incomplete Resection
title_sort treatment of intravenous leiomyomatosis with cardiac extension following incomplete resection
url http://dx.doi.org/10.1155/2015/756141
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