Uterine leiomyomatosis with intracardiac extension.

To cite: Thompson AT, Desai A, Ford SJ, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2016218234 DESCRIPTION A 40-year-old woman under investigation for a pelvic mass presented following a syncopal episode. A large fibroid-like pelvic mass and venous thrombus, extending from the left gonadal vein into the inferior vena cava and right atrium, were noted on CT scan (figures 1 and 2). She was referred to the nearest Sarcoma Unit; single-stage excision was planned. At laparotomy, a 28-week uterus was found. Total abdominal hysterectomy with bilateral salpingo-oophrectomy was performed. The full length of the inferior vena cava and left renal vein were exposed while median sternotomy was undertaken. Following aorto-atrial cannulation, the patient was cooled to 18°C to induce cardioplegia. In the chest, cavotomy was performed inferior to the right atrium. Simultaneously, another cavotomy was performed at the level of the left renal vein. The tumour