Intravenous leiomyomatosis (IVL) is a kind of very rare tumor, and IVL extending to the heart is even rarer and can lead to serious complications. The initial diagnosis of IVL generally depends on the history and imaging examination, and the final diagnosis depends on the postoperative pathological examination. The main treatment for IVL is complete surgical resection to reduce recurrence and close postoperative follow-up. This paper reported the process of diagnosis and treatment of a case with IVL extending to the heart and reviewed relevant literature, in order to provide reference for the clinical diagnosis and treatment of IVL.

1.Stewart EA, Cookson CL, Gandolfo RA, et al. Epidemiology of uterine fibroids: a systematic review[J]. BJOG, 2017, 124(10): 1501-1512. DOI: 10.1111/1471-0528.14640.

2.Chen J, Bu H, Zhang Z, et al. Clinical features and prognostic factors analysis of intravenous leiomyomatosis[J]. Front Surg, 2023, 9: 1020004. DOI: 10.3389/fsurg.2022. 1020004.

3.Miro A, Coppola Bottazzi E, Vanella S, et al. Intravascular leiomyomatosis with intracardiac extension: a toraco-abdominal approach[J]. J Surg Case Rep, 2021, 2021(6): rjab249. DOI: 10.1093/jscr/rjab249.

4.Birch-Hirschfeld FV. Lehrbuch der pathologischen anatomie[M]. Leipzig: F.C.W. Vogel, 1896: 226-258.

5.Chen YL, Zheng A, Han L. Intravascular leiomyomatosis with intracardiac extension: a case report[J]. Asian J Surg, 2022, 45(1): 500-501. DOI: org/10.1016/j.asjsur.2021.09.002.

6.Steiner PE. Metastasizing fibroleiomyoma of the uterus: report of a case and review of the literature[J]. Am J Pathol, 1939, 15(1): 89-110.7. https://pubmed.ncbi.nlm.nih.gov/19970436/.

7.Mandelbaum I, Pauletto FJ, Nasser WK. Resection of a leiomyoma of the inferior vena cava that produced tricuspid valvular obstruction[J]. J Thorac Cardiovasc Surg, 1974, 67(4): 561-567. https://pubmed.ncbi.nlm.nih.gov/4818531/.

8.Ma H, Cao J. Benign pulmonary metastasizing leiomyoma of the uterus: a case report[J]. Oncol Lett, 2015, 9(3): 1347-1350. DOI: 10.3892/ol.2015.2878.

9.Bakkensen JB, Samore W, Bortoletto P, et al. Pelvic and pulmonary benign metastasizing leiomyoma: a case report[J]. Case Rep Womens Health, 2018, 18: e00061. DOI: 10.1016/j.crwh.2018.e00061.

10.Marcus SG, Krauss T, Freedberg RS, et al. Pulmonary embolectomy for intravenous uterine leiomyomatosis[J]. Am Heart J, 1994, 127(6): 1642-1645. DOI: 10.1016/0002-8703(94)90404-9.

11.Shi T, Shkrum MJ. A case report of sudden death from intracardiac leiomyomatosis[J]. Am J Forensic Med Pathol, 2018, 39(2): 119-122. DOI: 10.1097/paf.0000000000000377.

12.Li B, Chen X, Chu YD, et al. Intracardiac leiomyomatosis: a comprehensive analysis of 194 cases[J]. Interact Cardiovasc Thorac Surg, 2013, 17(1): 132-138. DOI: 10.1093/icvts/ivt117.

13.Akatsuka N, Tokunaga K, Isshiki T, et al. Intravenous leiomyomatosis of the uterus with continuous extension into the pulmonary artery[J]. Jpn Heart J, 1984, 25(4): 651-659. DOI: 10.1536/ihj.25.651.

14.Tamburino C, Russo G, Incognito C, et al. Intracardiac extension of a calcified ovarian hemangioma-a case report[J]. Angiology, 1992, 43(3 Pt 1): 249-252. DOI: 10.1177/000331979204300310.

15.Lam PM, Lo KW, Yu MY, et al. Intravenous leiomyomatosis: two cases with different routes of tumor extension[J]. J Vasc Surg, 2004, 39(2): 465-469. DOI: 10.1016/j.jvs.2003.08.012.

16.Raposo MI, Meireles C, Cardoso M, et al. Benign metastasizing leiomyoma of the uterus: rare manifestation of a frequent pathology[J]. Case Rep Obstet Gynecol, 2018, 2018: 5067276. DOI: 10.1155/2018/5067276.

17.Consamus EN, Reardon MJ, Ayala AG, et al. Metastasizing leiomyoma to heart[J]. Methodist Debakey Cardiovasc J, 2014, 10(4): 251-254. DOI: 10.14797/mdcj-10-4-251.

18.桑秀波, 龚萍, 白文佩. 静脉内平滑肌瘤病9例临床分析[J]. 中国优生与遗传杂志, 2023, 31(11): 2312-2316. [Sang XB, Gong P, Bai WP. Clinical analysis of 9 cases of intravenous leiomyomatosis[J]. Chinese Journal of Birth Health & Heredity, 2023, 31(11): 2312-2316.] DOI: 10.13404/j.cnki.cjbhh.2023.11.007.

19.任健, 李晟辉, 刘勇. 子宫静脉内平滑肌瘤病51例临床分析[J]. 中国医刊, 2023, 58(6): 679-684. [Ren J, Li SH, Liu Y. Clinical analysis of 51 cases of intravenous leiomyomatosis[J]. Chinese Journal of Medicine, 2023, 58(6): 679-684.] DOI: 10.3969/j.issn.1008-1070.2023.06.027.

20.Ordulu Z, Chai H, Peng G, et al. Molecular and clinicopathologic characterization of intravenous leiomyomatosis[J]. Mod Pathol, 2020, 33(9): 1844-1860. DOI: 10.1038/s41379-020-0546-8.

21.Li J, Zhu H, Hu SY, et al. Case report: cardiac metastatic leiomyoma in an Asian female[J]. Front Surg, 2022, 9: 991558. DOI: 10.3389/fsurg.2022.991558.

22.Gwacham NI, Manyam M, Fitzsimmons CK, et al. Multidisciplinary approach to pelvic leiomyomatosis with intracaval and intracardiac extension: a case report and review of the literature[J]. Gynecol Oncol Rep, 2022, 40: 100946. DOI: 10.1016/j.gore.2022.100946.

23.Jiang S, Li Z, Ma X, et al. Robotic-assisted laparoscopic and thoracoscopic approach: a challenging multidisciplinary minimally invasive surgery of intravascular leiomyomatosis with intracardiac extension[J]. Fertil Steril, 2023, 119(1): 155-157. DOI: 10.1016/j.fertnstert.2022.09.022.

24.Ma G, Miao Q, Liu X, et al. Different surgical strategies of patients with intravenous leiomyomatosis[J]. Medicine (Baltimore), 2016, 95(37): e4902. DOI: 10.1097/md.0000000000004902.

25.Liang J, Lei R, Xie M, et al. The role of estrogen deprivation therapy in premenopausal women with primary unresectable intracardiac leiomyomatosis: a systematic review and meta-analysis[J]. Orphanet J Rare Dis, 2021, 16(1): 453. DOI: 10.1186/s13023-021-02087-7.

26.Peng J, Zhong F, Zhu Y, et al. Clinical analysis of uterine intravenous leiomyomatosis: a retrospective study of 260 cases[J]. J Obstet Gynaecol Res, 2021, 47(12): 4357-4364. DOI: 10.1111/jog.15013.

27.Yu X, Fu J, Cao T, et al. Clinicopathologic features and clinical outcomes of intravenous leiomyomatosis of the uterus: a case series[J]. Medicine (Baltimore), 2021, 100(1): e24228. DOI: 10.1097/md.0000000000024228.