Abstract. Intravenous leiomyomatosis (IVL) is defined as a benign smooth muscle tumor, growing within systemic veins. IVL with intracaval and intracardiac extension has rarely been reported in radiological and oncological journals. The present study describes 2 cases of IVL extending from the inferior vena cava to the right atrium and ventricle, and discusses the imaging findings and differential diagnosis of this tumor entity. The two patients, who complained of palpitations, shortness of breath or syncope, were surgically treated, with complete resection of the cardiac and intracaval tumors. Pathological examinations were suggestive of IVL. The postoperative course of the two patients was uneventful, and no signs of recurrence were observed on follow-up. Computed tomography and magnetic resonance imaging played a vital role in the diagnostic process and presurgical assessment. The results of the present study indicate that IVL should be considered upon presentation of a soft mass in systemic veins, even when the mass extends to the right cardiac chambers, in female patients, particularly in patients with a history of uterine myoma.

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