Intravascular leiomyomatosis with extension to the inferior vena cava

BMJ Case Rep. 2023 Jun 19;16(6):e253436. doi: 10.1136/bcr-2022-253436.


Intravascular leiomyomatosis (IVL) is a rare benign smooth muscle neoplasm growing within the pelvic venous system, often with caval and intracardiac extension. It frequently coexists with uterine leiomyomas or occurs in women with a history of myomectomy or hysterectomy. IVL is often asymptomatic until intracardiac extension occurs, and carries a risk of sudden death, necessitating timely diagnosis and management. We present a case of IVL diagnosed on hysterectomy specimen with extension to the inferior vena cava found on follow-up imaging. The patient underwent complete resection with multidisciplinary involvement of Gynaecological Oncology and Vascular Surgery and remains disease free following 12 months of follow-up.

Keywords: Gynecological cancer; Radiology; Ultrasonography; Vascular surgery.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Heart Neoplasms* / surgery
  • Humans
  • Hysterectomy
  • Leiomyomatosis* / diagnostic imaging
  • Leiomyomatosis* / surgery
  • Uterine Neoplasms* / diagnostic imaging
  • Uterine Neoplasms* / surgery
  • Vascular Neoplasms* / diagnostic imaging
  • Vascular Neoplasms* / surgery
  • Vena Cava, Inferior / diagnostic imaging
  • Vena Cava, Inferior / surgery