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Intravenous leiomyomatosis presenting as acute Budd-Chiari syndrome

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Presentation on theme: "Intravenous leiomyomatosis presenting as acute Budd-Chiari syndrome"— Presentation transcript:

1 Intravenous leiomyomatosis presenting as acute Budd-Chiari syndrome
Jason Barksdale, MD, Amir Abolhoda, MD, Farhood Saremi, MD  Journal of Vascular Surgery  Volume 54, Issue 3, Pages (September 2011) DOI: /j.jvs Copyright © Terms and Conditions

2 Fig 1 Postcontrast computed tomography (CT) images show extensive thrombosis of the hepatic veins (green arrows) with heterogeneous liver enhancement due to abnormal perfusion. Enhancing tumor is shown in the inferior vena cava (IVC; *). A T1W magnetic resonance (MR) image a few days later shows the thrombosed hepatic veins as bright signal intensities (green arrows). Note progressive pleural effusion and ascites. The postcontrast arterial-phase MRI shows the enlarged IVC containing tumor thrombus, which enhances on the venous and delayed-phase images. Sagittal T2W and coronal postcontrast images show a large enhancing exophytic mass arising from the superolateral aspect of the uterus and growing superiorly into the right gonadal vein and IVC. The inferior IVC is thrombosed. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © Terms and Conditions

3 Fig 2 A, Surgical specimen removed from the inferior vena cava (IVC). B, Corresponding postcontrast coronal computed tomography image shows the lower IVC is thrombosed and filled mostly with clot. The upper IVC is mostly occupied by the enhancing mass. The mass extends through the right gonadal veins (GV; blue arrows) and the IVC (red arrows) into the right atrium (green arrow). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © Terms and Conditions

4 Fig 3 Computed tomography images at the 3-month follow-up show a patent inferior vena cava (IVC). Residual thrombus is seen near the confluence of the hepatic veins with the IVC. Bilateral pleural effusion, mild ascites, and anasarca are still noted, and residual thrombosis of left iliac vein is seen. The right iliac vein is patent. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © Terms and Conditions

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