Case Report: A Case of Intravenous Leiomyomatosis Involving the Inferior Vena Cava and Right Atrium

Intravenous leiomyomatosis (IVL) is rare and is characterized by the extension of an aggressive, histologically benign tumor into venous channels and cardiac chambers. We report a case of advanced IVL to highlight its insidious presentation and the requisite multidisciplinary surgical approach. A patient presenting with nonspecific symptoms was incidentally diagnosed with stage III IVL with intracardiac extension. A multidisciplinary team performed a single-stage procedure that involved a total hysterectomy with bilateral adnexectomy and left ovarian vein resection, followed by right atrial tumor resection under extracorporeal circulation (without cardiac arrest), IVC tumor removal, and resection of a left renal vein tumor embolus. The surgery was successful, with an uneventful recovery. This case highlights that IVL can be asymptomatic until it reaches an advanced stage. A meticulous, single-stage multidisciplinary surgical strategy is feasible and effective for complete tumor resection, even in the presence of intracardiac involvement, ensuring optimal patient outcomes.