{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:13:48Z","timestamp":1753892028066,"version":"3.41.2"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T00:00:00Z","timestamp":1644192000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Intravascular leiomyomatosis is a rare benign lesion with malignant potential. The cases are sporadic. Most patients have no clinical symptoms, and the preoperative diagnostic rate is low. Case 1 was misdiagnosed, passively managed during operation, recurred quickly, and underwent a secondary operation. We learned lessons from case 1 and treated the case 2 patient differently. The case 2 patient had a good prognosis. We hope the report will be helpful to other gynecologists.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Summary<\/jats:title><jats:p>Case 1: a 49-year-old woman complained of dysmenorrhea. Traditional ultrasound showed adenomyosis and a solid mass 6 * 3 cm in the right appendix. After routine examination, the patient underwent transabdominal total hysterectomy + bilateral salpingectomy + IVL tumor resection, with both ovaries kept. No medication was used after operation. Routine ultrasound was performed every 3 months. The disease recurred, and the patient underwent a secondary surgery 9 months after the first time. So far, 25 months after the secondary surgery, there is no sign of recurrence. Case 2: a 41-year-old woman underwent a routine body examination, where a left adnexal mass 7 cm was found. The patient underwent contrast-enhanced ultrasonography and was diagnosed and prepared well preoperatively. The patient underwent transabdominal total hysterectomy + bilateral salpingectomy + IVL tumor resection. GnRH-a drugs were used after operation for 3 cycle. Now, there is no sign of recurrence after operation for 23 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The incidence rate of IVL is low, and there are no typical clinical symptoms. It is easy to be ignored by gynecologists. Contrast-enhanced ultrasound is helpful to diagnose preoperatively and reduce misdiagnosis. Good preparation, full exploration of the pelvic and abdominal vessels, removal of lesions completely as much as possible, and anti-estrogen therapy after operation can reduce the recurrence of disease.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2022.840096","type":"journal-article","created":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T05:09:45Z","timestamp":1644210585000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Gynecologists Need to Be Vigilant\u2014Two Case Reports of Intravascular Leiomyomatosis and Literature Review"],"prefix":"10.3389","volume":"12","author":[{"given":"Xiang","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ning-Ye","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Sheng","family":"Jiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,2,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.5090\/kjtcs.2011.44.3.243","article-title":"Pulmonary Artery Embolization of Intravenous Leiomyomatosis Extending Into the Right Atrium","volume":"44","author":"Lee","year":"2011","journal-title":"Korean J Thorac Cardiovasc Surg"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-008-9379-5","article-title":"Leiomyomatosis Peritonealis Disseminata and Subcutaneous Myoma\u2013A Rare Complication of Laparoscopic Myomectomy","volume":"34","author":"Thian","year":"2009","journal-title":"Abdom Imaging"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1097\/PGP.0b013e3181656dab","article-title":"Pulmonary Benign Metastasizing Leiomyoma Associated With Intravenous Leiomyomatosis of the Uterus: Clinical Behavior and Genomic Changes Supporting a Transportation Theory","volume":"27","author":"Lee","year":"2008","journal-title":"Int J Gynecol Pathol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1053\/j.ro.2020.06.009","article-title":"Case of the Season: Intravenous Leiomyomatosis: A Rare Cause of Intracardiac Mass","volume":"55","author":"Lee","year":"2020","journal-title":"Semin Roentgenol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1368-5031.2004.00085.x","article-title":"Angioleiomyoma: A Clinical, Pathological and Radiological Review","volume":"58","author":"Ramesh","year":"2004","journal-title":"Int J Clin Pract"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivt117","article-title":"Intracardiac Leiomyomatosis: A Comprehensive Analysis of 194 Cases","volume":"17","author":"Li","year":"2013","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1097\/aog.0b013e31826ebb90","article-title":"Management of Intravenous Leiomyomatosis With Intracaval and Intracardiac Extension","volume":"120","author":"Wang","year":"2012","journal-title":"Obstet Gynecol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/s0029-7844(02)02194-4","article-title":"Postmenopausal Intravenous Leiomyomatosis With High Levels of Estradiol and Estrogen Receptor","volume":"100","author":"Kokawa","year":"2002","journal-title":"Obstet Gynecol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"27","DOI":"10.2217\/fca-2019-0002","article-title":"Uterine Intravenous Leiomyomatosis With Femoral Vein, Intracaval, Intracardiac and Pulmonary Artery Extension","volume":"16","author":"Akinseye","year":"2020","journal-title":"Future Cardiol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/S0950-821X(05)80163-X","article-title":"Intravenous Leiomyomatosis of the Uterus","volume":"22","author":"Bodner","year":"2002","journal-title":"Anticancer Res"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2003.06.009","article-title":"Intravenous Leiomyomatosis Extending Into the Right Ventricle Associated With Pulmonary Metastasis and Extensive Arteriovenous Fistula","volume":"198","author":"Nishizawa","year":"2004","journal-title":"J Am Coll Surg"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/756141","article-title":"Treatment of Intravenous Leiomyomatosis With Cardiac Extension Following Incomplete Resection","volume":"2015","author":"Doyle","year":"2015","journal-title":"Int J Vasc Med"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1023\/A:1020511318806","article-title":"GnRH Agonist for Intravenous Leiomyomatosis With Cardiac Extension. 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