Intravenous leiomyomatosis (IVL) is a rare benign smooth muscle tumor that can extend into the heart, posing major anesthetic challenges. We report a 57-year-old woman with IVL extending from the uterus through the inferior vena cava into the right atrium. A multidisciplinary team performed single-stage intracardiac tumor resection under cardiopulmonary bypass with hysterectomy and bilateral salpingo-oophorectomy. Continuous transesophageal echocardiography (TEE) enabled real-time assessment of tumor mobility and safe cannulation. The patient recovered uneventfully. This case highlights the essential role of TEE and teamwork in managing IVL with intracardiac extension.
Kobayashi et al. (Fri,) studied this question.