Intravenous leiomyomatosis manifesting as a cardiac mass: a case report

This article reports a 45-year-old woman with intravenous leiomyomatosis (IVL) who presented with chest tightness and was initially diagnosed as a cardiac mass. Multimodal imaging, including contrast-enhanced pelvic CT and transthoracic echocardiography, revealed IVL extending from the pelvic veins through the inferior vena cava into the right atrium. The patient underwent multidisciplinary two-stage surgical resection. Histopathological and immunohistochemical examinations confirmed IVL, with positive α-SMA, desmin, CD10, ER, PR and negative HMB45, Melan-A, and S100. Only short-term postoperative imaging data are available at the time of writing; long-term follow-up is ongoing, and the lack of extended follow-up data represents a limitation given the known recurrence risk of IVL. This case emphasizes the rarity of IVL presenting as a cardiac mass and the value of multidisciplinary diagnosis and treatment.