Surgical Strategy of Intravenous Leiomyomatosis with Intracardiac Extension: A Case Report

Intravenous leiomyomatosis with intracardiac extension is a rare benign tumor originating from uterine smooth muscle. A 50-year-old woman presented with a cardiac mass 3 years after hysterectomy. Imaging revealed a tumor extending from the right internal iliac vein to the right atrium. Complete resection was achieved via a 2-stage surgery. In the 1st stage, median sternotomy and a retroperitoneal approach were performed, and the intracardiac tumor was excised under deep hypothermic circulatory arrest with cardiopulmonary bypass. Postoperatively, gonadotropin-releasing hormone (GnRH) agonist therapy was administered, followed by a 2nd-stage resection of the residual pelvic tumor and right ovary. The patient remained recurrence-free for 15 months.