Intravenous leiomyomatosis (IVL) is a rare and specific type of uterine leiomyoma. Leiomyomas usually grow into the venous blood vessels or form tumors by proliferation of the smooth muscle tissue of the wall of the venous blood vessels themselves that protrude into the lumen of the vessels; their histopathology is benign, but they have undesirable biological behaviors such as invasion of the veins and extend into the inferior vena cava through the uterine veins and ovarian veins, often involving the right heart or pulmonary arteries. It extends through the uterine and ovarian veins into the inferior vena cava, often involving the right heart or pulmonary artery. Involvement of the heart or lungs is called intracardiac leiomyomatosis (ICL). About 200 cases of ICL have been reported in the literature at home and abroad. In August this year, Associate Professor Zhang Yan of the Department of Obstetrics and Gynecology of Peking University First Hospital came to the outpatient clinic with a special patient, whose enlarged abdomen showed a huge pelvic mass and was accompanied by chest tightness, which was initially considered to be a huge smooth muscle tumor. Zhang Yan urgently contacted the echocardiography unit and saw a solid displacement in the inferior vena cava, extending to the right ventricle, and mild pulmonary hypertension. So, the Obstetrics and Gynecology Department asked Dr. Li Xihui, Associate Chief of Cardiac Surgery, to view the patient and then admitted the patient to the Cardiac Surgery Ward. After admission, the patient’s laboratory tests were rapidly improved with the close cooperation of Medical Imaging, Interventional Vascular Surgery, Nuclear Medicine and Laboratory. The Medical Department organized and coordinated a hospital-wide consultation with experts from various departments: Professor Yang Yinmo from General Surgery, Professor Liao Qinping from Obstetrics and Gynecology, Associate Professor Zhang Yan, Attending Physician He Yingdong, Chief Physician Xiao Feng from Cardiac Surgery, Chief Physician Li Yan, Associate Professor Wang Jin, and Associate Chief Physician Li Xihui, who had a number of enthusiastic discussions, ranging from pathophysiology to pathogenesis, from principles of treatment to details of nursing care, and from preoperative preparations to postoperative precautions. The experts considered the treatment plan one by one: the patient’s tumor was very extensive, involving the pelvis, abdominal cavity, heart and lungs, so the surgery was extremely risky and needed to be performed in stages, one by one; the mass originated from the pelvis, so the obstetrics and gynecology department and the general surgery department could perform the resection of the pelvic and abdominal masses, and then the cardiac surgery department could perform the resection of the cardiac and intravascular masses. However, this raises an issue: heparinization is required during cardiac surgery, and uncontrolled bleeding may occur from the pelvic-abdominal surgical wound, which could be fatal to the patient in a tight blood supply. However, if the cardiac and intravascular masses are removed first, it may not be possible to remove the intravascular masses cleanly due to the presence of the pelvic-abdominal mass, increasing the risk of postoperative recurrence in the patient. After discussion, the first plan was implemented, in which the pelvic and abdominal masses were resected first, and intraoperative hemostasis was strictly applied to ensure that the patient’s masses could be completely resected. After thorough and adequate preoperative preparation, the surgery was performed on August 21 in the operating room of the center. Dr. Liu Xiaoying, Chief of Anesthesiology, anesthetized the patient, Prof. Liao Qinping, Chief of Obstetrics and Gynecology, and Dr. He Yingdong, Attending Physician, closely cooperated with Dr. Liu Xiaoying, Chief of Anesthesiology, and Prof. Yang Yinmo, Professor of General Surgery, assisted in the surgery to perform resection of the huge pelvic mass. Dr. Yin Ling, deputy director of the Department of Obstetrics and Gynecology, also rushed to the central operating room to pay attention to the operation, and what she saw during the operation was a great pressure: the pelvic mass was very large and had infiltrative growth to the surrounding tissues, and it was impossible to distinguish the obvious parietal structures; the gap between the bladder and the uterus could not be separated due to the compression of the mass; the blood vessels supplying the ovaries bilaterally were three times as big as the diameter of the normal lumen due to the occupation of the mass. 3 times …… Inside the operating room, professors were concentrating on the surgery; outside the operating room, the second line of cardiovascular medicine was on standby, the blood bank was ready for blood allocation, and the family members were praying in silence. …… After hours of hard work, the huge tumor with a diameter of 24cm in the pelvic cavity was finally completely resected. The huge tumor in the pelvis with a diameter of 24cm was finally completely removed. Cardiac Surgery took over and continued the operation. Dr. Li Xi Hui, Associate Chief Physician, Associate Professor Wang Jin, and Resident Dong Shiyong methodically opened the chest to set up the extracorporeal circulation, while Prof. Xiao Feng calmly directed the operation at the operating table. With the help of Prof. Yinmo Yang, the operator opened the abdomen to expose the inferior vena cava and iliac vein. When the extracorporeal circulation was cooled down to 28 degrees Celsius and the blood flow of the whole body was reduced to half, the heart and the inferior vena cava were cut open, and the intracardiac mass and the inferior vena cava mass were completely removed by the surgical operation of “up and down convergence”, and the tumors in the iliac veins on both sides were also completely removed afterwards. After 9 hours of long and intense surgery, the mass was successfully removed! The patient was admitted to the Cardiac Surgery Unit after the surgery and all was well after the first 24 hours! The patient was transferred from the Cardiac Surgery Care Unit to the general ward; she was finally safely out of harm’s way and the patient was saved! All the healthcare professionals in the Obstetrics and Gynecology Department, Cardiac Surgery Department, Anesthesiology Department, and Operating Room …… who were silently wishing her well breathed a sigh of relief! The patient was cured and discharged from the hospital 2 weeks after the operation. 3 months have passed, and the follow-up patient indicated that she has recovered well and there is no sign of tumor recurrence or metastasis at present. Although the patient’s treatment was critical, it was well organized. With the joint efforts of the sister departments, Peking University Hospital saved the patient’s life once again, and once again rewarded the patient’s trust and confidence! Efficient multidisciplinary cooperation and concerted collaboration has always been a good practice of Peking University Hospital in the process of rescuing critically ill patients, and it is a vivid embodiment of the spirit of the motto of Peking University Hospital: “Virtue and Virtuousness”, which highlights the strong strength of Peking University Hospital’s complete range of disciplines and high level of comprehensive diagnosis and treatment, and that the patient’s health is the main concern of all the medical and nursing staff of Peking University Hospital. The health of patients is the wish of all the medical and nursing staff of Peking University Hospital, and we will continue to work hard to promote the improvement of people’s health!