A 47-year-old female patient presented with progressive dyspnea on exertion, abdominal pain, loss of weight and tachycardia. The diagnosis of a retroperitoneal tumor with invasion of the vena cava inferior up to the right atrium was established by computed tomography. The patient was referred for echocardiographic assessment of cardiac involvement before surgery. It is worth noting that the patient had a history of hysterectomy under the histopathological diagnosis of leiomyoma ten years ago. Findings, diagnosis and discussion