CTICasesIntravenous Leiomyomatosis
Imaging findings
CT chest from the Mallinckrodt archives shows a large, lobulated, contiguous soft-tissue mass extending from the pelvic veins into the inferior vena cava, through the right atrium, and all the way into the main pulmonary artery, causing partial vascular obstruction and associated pulmonary emboli.
Key takeaways
Intravenous leiomyomatosis (IVL) is a rare, histologically benign smooth muscle tumor arising from the uterus that proliferates within the uterine and pelvic veins. It can extend contiguously into the IVC and right heart chambers (intracardiac leiomyomatosis), and occasionally into the pulmonary arteries. Although benign, it behaves aggressively by causing vascular obstruction and requires complete surgical resection of both the cardiac and pelvic components.
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