Intravascular leiomyomatosis.

Two cases of intravascular leiomyomatosis are described. In 1 case, a 66-year-old woman was seen with an extension of the tumor to the myometrium, cervix, and left parametrium and with radiologic evidence of tumor extension to the left external and common iliac veins and the inferior vena cava; subsequently, the tumor invaded the left renal, suprarenal and ovarian veins, hepatic veins, and the right atrium, causing severe heart failure and death. The second case is that of a 28-year-old woman with an advanced tumor in the interior vena cava, right atrium, and ventricle who died during cardiac surgery. Review of the literature is presented, with special comment on the management of this disease entity.