Intravenous leiomyomatosis is a rare tumor arising either from a uterine leiomyoma or from uterine vessel walls with extension into venous channels. Although intravenous leiomyomatosis is considered histologically "benign," intrusion to the cardiac chambers is almost malignant given its possibility for destruction of heart valves, extending into the pulmonary vasculature, and embolizing. We report a patient with an intravenous leiomyomatosis progressing through the left iliac vein, along the entire vena cava up to the right cardiac chambers and branches of pulmonary artery (PA), and review the literature on this subject.

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