盆腔内静脉内平滑肌瘤病理报告1例
A Case Report: Intrapelvic Venous Leiomyoma

目的：了解盆腔静脉内平滑肌瘤(Intrapelvic Venous Leiomyoma, IVL)的临床特点，鉴别诊断和治疗方法。方法：回顾性分析我院2024年1月住院手术并经病理证实的1例静脉内平滑肌瘤病例。结果：患者以“腹痛5天，加重半天”之主诉入院。于我院行腹腔镜下盆腔粘连松解 + 全子宫双附件切除术。取标本送病理检查，病理诊断：考虑静脉内平滑肌瘤(病理号：24-00729)妇科B超示：宫颈肥大，回声不均匀(5.2 × 4.6 cm)。术后切口愈合良好。结论：静脉内平滑肌瘤是一类罕见的妇科良性肿瘤，大多数为隐匿性起病，IVL的镜下组织结构与子宫肿瘤类似，临床上往往被误诊、漏诊，因此，对子宫肌瘤或子宫肌瘤手术史的患者，出现盆腔包块、阴道壁肿物、下腔静脉或心腔内肿物时，均应考虑本病的可能性，一旦发现应尽早手术切除，避免其继续进展。
To understand the clinical characteristics, differential diagnosis and treatment of leiomyoma in the pelvic vein. Method: Retrospective analysis of our institute A case of intravenous leiomyoma confirmed by hospitalization in January 2024. Results: The patient was admitted to the hospital with “abdominal pain for 5 days, aggravated for half a day”. Laparoscopic pelvic adhesion loosening + total uterine double accessory resection was performed in our hospital. Take specimens and send them for pathological examination, pathological diagnosis: consider intravenous leiomyoma (pathological number: 24-00729). B-ultrasound: cervical hypertrophy, uneven echo (5.2 × 4.6 cm). The postoperative incision heals well. Conclusion: Intravenous leiomyoma is a rare gynecological benign tumor, most of which are occult onset. The microscopic tissue structure of IVL is similar to that of uterine tumors. Clinically, it is often misdiagnosed and missed. Therefore, for patients with a history of surgery for uterine fibroids or uterine fibroids, there are pelvic mass, wall tumors, inferior vena cava or heart. When there is a tumor in the cavity, the possibility of the disease should be considered. Once it is found, it should be surgically removed as soon as possible to avoid its continued development.