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Sudden Death by Pulmonary Thromboembolism due to a Large Uterine Leiomyoma with a Parasitic Vein to the Mesentery.

Podduturi V, Armstrong-Briley DR, Guileyardo JM - Case Rep Obstet Gynecol (2014)

Bottom Line: The pathophysiology of venous thrombosis is classically attributed to alterations in one or more components of Virchow's triad: hypercoagulability, stasis, and damage to the vascular endothelium.Deep vein thrombosis (DVT) may lead to pulmonary thromboembolism (PE), and the latter is culpable for many deaths annually in the United States; however, DVT as a complication of uterine leiomyoma has rarely been reported.We report a case of a 57-year-old woman whose death was due to a large pedunculated subserosal leiomyoma externally compressing the pelvic veins resulting in stasis and venous thrombosis leading to fatal PE.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Baylor University Medical Center, Dallas, TX, USA.

ABSTRACT
The pathophysiology of venous thrombosis is classically attributed to alterations in one or more components of Virchow's triad: hypercoagulability, stasis, and damage to the vascular endothelium. Deep vein thrombosis (DVT) may lead to pulmonary thromboembolism (PE), and the latter is culpable for many deaths annually in the United States; however, DVT as a complication of uterine leiomyoma has rarely been reported. We report a case of a 57-year-old woman whose death was due to a large pedunculated subserosal leiomyoma externally compressing the pelvic veins resulting in stasis and venous thrombosis leading to fatal PE. The association of large pelvic masses with venous thrombosis has clinical implications, since prophylactic surgery could be life-saving.

No MeSH data available.


Related in: MedlinePlus

Vessel from the leiomyoma parasitizing to the mesentery.
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fig2: Vessel from the leiomyoma parasitizing to the mesentery.

Mentions: Autopsy found a normally developed, moderately obese woman. An oral endotracheal tube was well positioned. A 1275-gram, 14.8 × 14.2 × 9.4 cm subserosal pedunculated tan-white uterine nodule extended from the fundus and filled the entire pelvis with extension into the lower abdominal cavity. A vein from the surface of the nodule anastomosed with an adjacent small bowel mesenteric vein (Figure 2). The myometrium also contained smaller intramural and subserosal nodules ranging in size from 0.7 cm to 2.2 cm in diameter. Cut sections of all nodules were whorled and tan-white. Multiple laminated and focally adherent hilar and peripheral intravascular thrombi were present in all lobes of both lungs. Posterior leg dissection found thrombi in bilateral posterior tibial veins and deep gastrocnemius veins.


Sudden Death by Pulmonary Thromboembolism due to a Large Uterine Leiomyoma with a Parasitic Vein to the Mesentery.

Podduturi V, Armstrong-Briley DR, Guileyardo JM - Case Rep Obstet Gynecol (2014)

Vessel from the leiomyoma parasitizing to the mesentery.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4283384&req=5

fig2: Vessel from the leiomyoma parasitizing to the mesentery.
Mentions: Autopsy found a normally developed, moderately obese woman. An oral endotracheal tube was well positioned. A 1275-gram, 14.8 × 14.2 × 9.4 cm subserosal pedunculated tan-white uterine nodule extended from the fundus and filled the entire pelvis with extension into the lower abdominal cavity. A vein from the surface of the nodule anastomosed with an adjacent small bowel mesenteric vein (Figure 2). The myometrium also contained smaller intramural and subserosal nodules ranging in size from 0.7 cm to 2.2 cm in diameter. Cut sections of all nodules were whorled and tan-white. Multiple laminated and focally adherent hilar and peripheral intravascular thrombi were present in all lobes of both lungs. Posterior leg dissection found thrombi in bilateral posterior tibial veins and deep gastrocnemius veins.

Bottom Line: The pathophysiology of venous thrombosis is classically attributed to alterations in one or more components of Virchow's triad: hypercoagulability, stasis, and damage to the vascular endothelium.Deep vein thrombosis (DVT) may lead to pulmonary thromboembolism (PE), and the latter is culpable for many deaths annually in the United States; however, DVT as a complication of uterine leiomyoma has rarely been reported.We report a case of a 57-year-old woman whose death was due to a large pedunculated subserosal leiomyoma externally compressing the pelvic veins resulting in stasis and venous thrombosis leading to fatal PE.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Baylor University Medical Center, Dallas, TX, USA.

ABSTRACT
The pathophysiology of venous thrombosis is classically attributed to alterations in one or more components of Virchow's triad: hypercoagulability, stasis, and damage to the vascular endothelium. Deep vein thrombosis (DVT) may lead to pulmonary thromboembolism (PE), and the latter is culpable for many deaths annually in the United States; however, DVT as a complication of uterine leiomyoma has rarely been reported. We report a case of a 57-year-old woman whose death was due to a large pedunculated subserosal leiomyoma externally compressing the pelvic veins resulting in stasis and venous thrombosis leading to fatal PE. The association of large pelvic masses with venous thrombosis has clinical implications, since prophylactic surgery could be life-saving.

No MeSH data available.


Related in: MedlinePlus