Benign Metastatic Leiomyoma: Unusual Heart Location

Cardiac smooth muscle tumors are rare; three different clinical settings for these tumors have been reported, including benign metastasizing leiomyoma from the uterus, primary cardiac leiomyoma and leiomyosarcoma, and intravenous cardiac extension of pelvic leiomyoma, which is the most common. We present a case of a 56-year-old woman with a benign metastasizing leiomyoma to the heart without associated pulmonary localization 15 years after endoscopic vaginal myomectomy of polymyomatous uterus. Immunohistochemical stains for H-Caldesmon, Desmin, and estrogen, progesterone receptors were positive, indicating a smooth muscle tumor of uterine origin. To our knowledge, this is only the fifth reported case of benign metastasizing leiomyoma to the heart with histological proof and the first case of earlier onset cardiac metastasis without pulmonary metastasis localization. It illustrates that benign metastasizing leiomyoma should be included in the differential diagnosis of cardiac tumors in patients with a history of surgery uterine leiomyoma perfectly benign.