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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

Sections from large and small nodules find smooth muscle fascicles (H&E 400x).
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fig3: Sections from large and small nodules find smooth muscle fascicles (H&E 400x).

Mentions: Microscopically, the myometrial nodules consisted of smooth muscle fascicles with areas of interstitial hyalinization (Figure 3). No coagulation necrosis or mitotic figures were identified; and the masses were classified as leiomyomas. Sections from the leg veins and lungs showed laminated thrombi (Figure 4) with focal endothelial organization (Figure 5). Additional autopsy findings included cardiomegaly (485 grams) with atherosclerotic and hypertensive cardiovascular disease and diffuse alveolar damage. Postmortem studies to investigate for hypercoagulability, including MTHFR (methylenetetrahydrofolate reductase), prothrombin G20210A, and factor V Leiden mutations, were performed and were negative.


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)

Sections from large and small nodules find smooth muscle fascicles (H&E 400x).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig3: Sections from large and small nodules find smooth muscle fascicles (H&E 400x).
Mentions: Microscopically, the myometrial nodules consisted of smooth muscle fascicles with areas of interstitial hyalinization (Figure 3). No coagulation necrosis or mitotic figures were identified; and the masses were classified as leiomyomas. Sections from the leg veins and lungs showed laminated thrombi (Figure 4) with focal endothelial organization (Figure 5). Additional autopsy findings included cardiomegaly (485 grams) with atherosclerotic and hypertensive cardiovascular disease and diffuse alveolar damage. Postmortem studies to investigate for hypercoagulability, including MTHFR (methylenetetrahydrofolate reductase), prothrombin G20210A, and factor V Leiden mutations, were performed and were negative.

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