Intravenous leiomyomatosis is a histologically benign
smooth-muscle tumor arising from either a uterine myoma or the walls of
a uterine vessel with extension into veins. Echocardiographic features
of two cases of intravenous leiomyomatosis with extensive spread into
the right-sided cardiac chambers and pulmonary arteries are described.
Both patients were middle-aged women, with prior history of
hysterectomy 12 and 10 years earlier who presented with cardiac
symptoms and signs. Distinctive echocardiographic features include 1)
elongated mobile masses extending from the veins of the lower body,
including inferior vena cava and azygos vein; 2) multiple venous
attachments or metastases; and 3) filling of venous vessels and
right-heart chambers. Intracardiac leiomyomatosis should be considered
in a female patient presenting with an extensive mass in the
right-sided cardiac chambers.