血管内平滑肌瘤病（IVL）是起源于子宫的组织学上良性的平滑肌瘤，能够通过盆腔静脉蔓延，且在极少数情况下经下腔静脉一直扩展至心脏。尽管具有良性特征，但如果不加治疗，它可以表现为恶性肿瘤，导致明显的发病率，并且甚至可能导致死亡。患者为42岁的女性，曾有子宫肌瘤的病史。她出现了大量出血和频繁的点滴，因此前往妇科医生那里就诊。经过进一步评估，发现子宫内有一个肿块，它扩展到盆腔静脉、下腔静脉和右心房内。在完全切除肿块后，患者恢复良好。最终诊断为具有心脏扩展的IVL。尽管IVL罕见，但在曾行子宫切除术或肌瘤切除术的女性中，如果出现右心衰竭的症状，应考虑此病。理想的治疗需要多学科团队的支持，并且取决于患者的症状、先前手术史、肿瘤的扩展和可切除性。”© 2023. BioMed Central Ltd., part of Springer Nature.

Intravascular leiomyomatosis (IVL) is a histologically benign smooth muscle tumor arising from the uterus that can spread through the pelvic veins and, on rare occasions, extend as far as the heart via the inferior vena cava. Despite its benign characteristics, it can behave like a malignant tumor leading to significant morbidity and even mortality if left untreated.The patient is a 42-year-old woman with a past medical history of uterine leiomyomas. She presented with heavy bleeding and frequent spotting; therefore, she went to her gynecologist. After further evaluation, a mass within the uterus that expanded into the pelvic veins, inferior vena cava, and right atrium was discovered. After the complete removal of the mass, the patient underwent full recovery. IVL with cardiac extension was the final diagnosis.Although IVL is rare, it must be considered in women who underwent previous hysterectomies or myomectomies and present with symptoms of right heart failure. The ideal therapy will need the aid of a multidisciplinary team and will depend on the patient's symptoms, previous operative history, the tumor's extension, and resectability.© 2023. BioMed Central Ltd., part of Springer Nature.