Сlinical case of a rare and poorly studied disease – intravenous leiomyomatosis (IVL) is presented. Presented the literature data and our own clinical case of this rare pathology with dissemination to the v. cava inferior, to the right ventricle of the heart. The radiology semiotics of metastatic intravenous leiomyomatosis is described, the advantages and limitations of the methods of radiation diagnosis are noted. The clinical case is of particular interest, because there is a combination of simultaneous intravenous injury, heart damage and benign metastatic lung injury. The final diagnosis is verified by the data of morphological and molecular-genetic research based on the results of surgical intervention.