Cardiac extension of intravenous leiomyomatosis with successful resection

A case of intravenous leiomyomatosis spreading to the right ventricle is described. A 28-year-old woman had been previously diagnosed as having a smooth muscle tumor of borderline malignancy after hysterectomy for a large uterine tumor, because of its unusual invasive character. Based on the above diagnosis, the patient had been managed clinically as having a uterine sarcoma. One year after her hysterectomy, a local recurrence in the pelvic cavity was detected. Two years later, the tumor appeared as a cardiac tumor causing syncope. The tumor was totally resected in two surgical stages, and the correct diagnosis of an intravenous leiomyomatosis was made. The diagnostic and operative considerations are reviewed and the preferred surgical procedure is discussed.