An unexpected diagnosis of intravascular leiomyomatosis was made during a laparoscopic procedure. As the extent of the disease was unknown, the initial procedure was limited to laparoscopic hysterectomy and salpingo-oophorectomy. Postoperative computed tomography imaging demonstrated intravascular leiomyomatosis extending into the suprarenal inferior vena cava. The patient underwent exploratory laparotomy to excise residual tumor.
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