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Eur J Cardiothorac Surg 1998;14:635-638
© 1998 Elsevier Science NL

Case report

Asymptomatic right atrial leiomyosarcoma with tricuspid valve obstruction in a young female patient

Department of Cardiac Surgery, Ludwig-Maximilian-University, Munich, Klinikum Großhadern, Munich, Germany

Received 7 May 1998; received in revised form 9 September 1998; accepted 29 September 1998.

Corresponding author. Tel.: +49-89-7095-2433/2633; fax: +49-89-7095-8898.

Primary cardiac leiomyosarcomas of the heart are rare tumors usually diagnosed post-mortem. Like other sarcomas located in the heart, it causes symptoms by obstruction or occlusion of cardiac cavities, local invasion, embolization or by systemic manifestations. We present an unusual case of a previously healthy young female patient who was accidentally diagnosed with a cardiac tumor of unknown origin during routine physical examination in May 1997. Until a few days prior to elective cardiac surgery for diagnostic purposes in June 1997, no clinical symptoms were present. To our surprise, a primary right atrial leiomyosarcoma was found which almost completely occluded the right atrium and destroyed the tricuspid valve. Despite the combination of surgical removal and adjuvant chemotherapy the patient died 3 weeks after the operation due to progressive tumor disease and development of congestive heart failure and lung embolism.

Key Words: Cardiac leiomyosarcoma • Heart tumor • Palliative resection • Adjuvant therapy