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Anestheic Management of a Patient with Intravenous Leiomyomatosis Extending into the Right Atrium. Intravenous leiomyomatosis (IVL) is a condition in which leiomyoma originating from uterine myoma or intrauterine venous walls develops intravenously. A single-stage operation was planned by the departments of gynecology and cardiovascular surgery for a patient in which the IVL was extended across the tricuspid valve. It was possible to safely perform perioperative care with continued evaluation of the tumor position and intravascular volume through the use of transesophageal echocardiography (TEE). TEE can be useful in the intraoperative care of patients with intracardiac tumor extension as in this case.