We describe for the first time the usefulness of transesophageal echoc
ardiography for the identification of a primary leiomyoma of the infer
ior vena cava, which originated near its junction with the right atriu
m. A portion of the tumor was initially visualized in the right atrium
during a transthoracic echocardiographic study, but its attachment in
the inferior vena cava was evident only by transesophageal echocardio
graphy using the transgastric approach.