Turkiye Klinikleri J Case Rep 2018;26(1):11-4 11 ntravenous leiomyomatosis is a benign tumour of smooth muscle cells that develops inside the veins. It generally originates from the uterus and grows towards the pelvic veins and the inferior vena cava. It rarely reaches the right ventricle or atrium region of the heart. 1 Although this tu- mour is considered as a vascular hamartoma, it is reported that mechanical and hormonal factors are present in the pathogenesis. 2,3 Our case, which was histopathologically diagnosed as intravenous leiomyomatosis limited to the myometrium, was discussed in the light of the literature. CASE REPORT A 32-year-old, married, gravida 4, parity 2, abortus 2 case who had men- strual irregularity as menometrorrhagia (uterine bleeding for up to 15 days each menstrual period) for 2 years, was admitted to our clinic due to grad- ual increase of residual bleedings and fatigue. The patient was hypotensive (BP: 80/40 mmHg), had tachycardia (128/min) and of pale appearance, and the uterus was of 16 weeks size, and on the vaginal ultrasonography, a 13x12 cm-sized mixed echoic fibroid nucleus was visualized (Figure 1). In the lab- oratory examinations, the hemoglobin value was measured as 4.5 g/dl as se- vere anemia due to bleeding. An operation was planned following recovery of the case’s blood values and vital signs following replacement treatment. Preoperatively, a fibroid nucleus close to the uterine posterior surface at the fundal region with approximately 15 cm diameter was visualized. During enucleation, the mass was observed to possess finger-like extensions and par- tial vascular vegetating small protrusions. As a result of intraoperative pathol- A Giant Uterine Vascular Leiomyomatosis; A Rare Cause of Menometrorrhagia ABSTRACT Uterine angioleiomyoma is a rare type of leiomyoma originating from smooth muscle cells, containing thick-walled vessels. These tumoural lesions of mesenchymal origin can develop from all smooth muscle-containing tissues. The etiology of angioleiomyomas is still unclear. There are only a few cases of uterine intramural angioleiomyoma reported in the literature. Herein, we present the ultrasonographic and histopathological findings of a symptomatic patient with a pelvic intramural uterine angioleiomyoma, which clinically caused severe anemia. Keywords: Uterus; angiomyoma; metrorrhagia; anemia Özer BİRGE, a Ertuğrul Gazi ÖZBEY, b Feyza DEMİR, c Mehmet ADIYEKE, d Fevzi BEDİR, e İlkan KAYAR f Departments of a Gynecology and Obstetrics, b Urology, c Pathology, Nyala Sudan Turkey Training and Research Hospital, Nyala-Darfur-Sudan d Clinic of Gynecology and Obstetrics, Bergama State Hospital, İzmir e Department of Urology, Erzurum Region Training and Research Hospital, f Department of Gynecology and Obstetrics, Osmaniye State Hospital, Osmaniye Received: 18.10.2015 Received in revised form: 15.11.2015 Accepted: 04.12.2015 Available online: 15.02.2018 Correspondence: Özer BİRGE Nyala Sudan Turkey Training and Research Hospital, Department of Gynecology and Obstetrics, West Alezza District Southern Nyala- Darfur-SUDAN ozbirge@gmail.com Copyright © 2018 by Türkiye Klinikleri DOI: 10.5336/caserep.2015-48358 CASE REPORT