Intravenous leiomyomatosis is a rare growth pattern of benign uterine leiomyomas. Approximately 300 cases of intravenous leiomyomatosis have been reported in the English literature; however, there have only been a few in radiology journals. Even more rare is its extension through the inferior vena cava and heart chambers. Radiologic diagnosis can be challenging, as it is often difficult to differentiate it from other entities. We present a case of a 45-year-old woman with a cardiac extension of an intravenous leiomyomatosis and discuss the cross-sectional imaging appearance of this entity as well as the differential diagnosis.
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