Intravenous leiomyomatosis of the uterus extending through the inferior vena cava into the right cardiac cavities

Intravenous leiomyomatosis (IVL) is a rare neoplastic condition characterised by nodular masses of histologically benign smooth muscle growing within veins. In most cases, the disease is confined to the pelvic veins, but involvement may extend to the inferior vena cava (IVC) and right heart chamber. We present an unusual case of uterine leiomyoma that progressed along the IVC into the right atrium (RA) and right ventricle (RV). Various radiology modalities are available for the preoperative diagnosis of IVL. She was operated successfully through the first step of two-stage approach, failed to be resuscitated because of brain death secondary to severe right heart failure.