# MRI Features of Intravenous Leiomyomatosis

## TL;DR

This paper describes an MRI case study of a rare uterine tumor called intravenous leiomyomatosis in a 42-year-old woman.

## Contribution

The study highlights MRI features that can help identify intravenous leiomyomatosis, such as serpiginous intravascular extensions and absence of diffusion restriction.

## Key findings

- MRI showed a heterogeneous myometrial mass with serpiginous extensions along iliac veins.
- The lesion had high signal on high b-value diffusion-weighted images and high apparent diffusion coefficient values.
- Histopathology confirmed the diagnosis of intravenous leiomyomatosis after surgery.

## Abstract

Intravenous leiomyomatosis is a rare benign uterine smooth muscle tumor with intravascular growth through pelvic veins or lymphatics. A case is reported of a 42-year-old woman with intermittent spotting and progressive abdominal enlargement. Pelvic magnetic resonance imaging showed a heterogeneous myometrial mass with serpiginous extensions along iliac veins. The lesion had high signal on high b-value diffusion-weighted images and high apparent diffusion coefficient values, indicating the absence of diffusion restriction. After surgery, histopathology confirmed the diagnosis of intravenous leiomyomatosis.

Teaching point: Recognition of serpiginous intravascular extensions and the absence of diffusion restriction on magnetic resonance imaging should raise suspicion for intravenous leiomyomatosis.