Abstract
Although intravenous extension of uterine leiomyosarcomas has been described, extension into the inferior vena cava (IVC) and right atrium, so-called 'intravenous leiomyosarcomatosis (IVLS)', is rare. To our knowledge only a few cases have been described in the literature. We describe a case of recurrent uterine leiomyosarcoma to the retrohepatic IVC. The patient was initially treated with total abdominal hysterectomy. Follow-up computed tomography a year later showed an extensive intravascular and intracardiac soft tissue mass treated with tumor extraction using cardiac bypass. Five years later she presented to our institution with a new retrohepatic caval mass treated with surgical resection and caval grafting. IVLS is a rare disease that is best treated with surgical resection even in the recurrent setting. The role of adjuvant therapy remains unclear.