A rare case of Intravascular fibroid incidentally diagnosed
A 47-year-old P2L2 presented with complaints of abdominal distension and vague abdominal pain for 8 months.

Ultrasound revealed a large intramural fibroid and she has consented to a total laparoscopic hysterectomy.
During dissection of the posterior peritoneum and skeletonization of the uterine vessels demonstrated that the left uterine vein appeared abnormally enlarged and a mass was felt inside the vein's lumen.

The contralateral uterine vein appeared normal. An intravascular leiomyoma was suspected and following coagulation and dissection of the left uterine vein, the leiomyoma was seen protruded from the divided end of the vessel wall.

Its extent was determined by an atraumatic grasper, with further peritoneal dissection to fully visualize the ureters. The mass extended to the internal iliac vein but not beyond.

It was removed from the vessel wall and sent for histopathology, which confirmed it as a benign leiomyoma.

The Journal of Minimally Invasive Gynecology
Source: https://doi.org/10.1016/j.jmig.2021.08.022
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