Key result
Emergent surgical resection of a right ventricular metastatic tumor from uterine leiomyosarcoma, followed by chemotherapy, prevented sudden death and resulted in a complete response.
Why the study?
Metastatic cardiac tumors from uterine leiomyosarcoma are very rare, typically asymptomatic, and rarely undergo surgical resection when concurrent lung metastases are present.
Case Report (n=1)
Emergent surgical resection of cardiac metastatic tumors from uterine leiomyosarcoma should be considered to prevent sudden death.
Cardiac metastases from uterine leiomyosarcoma warrant vigilance in symptomatic patients; this case extends sparse antemortem documentation.
Uterine leiomyosarcoma is a malignant soft tissue tumor resembling uterine fibroma clinically and is difficult to diagnose preoperatively. Since metastatic cardiac tumors are very rare and asymptomatic, most cardiac metastases are detected at autopsy after death due to other diseases. A 49-year-old woman presented with menorrhagia and anemia, and a uterine tumor. Total hysterectomy was performed for the uterine tumor. Histopathological examination revealed the tumor to be a leiomyosarcoma. Postoperative computed tomography showed multiple lung metastases and a metastatic cardiac tumor. The cardiac tumor, which was located within and almost entirely occluded the right ventricle, was 49 × 26 mm. To prevent sudden death, cardiac tumorectomy was performed semi-emergently. Chemotherapy was initiated in the early postoperative period, and the patient currently maintains a complete response. Cases with lung and cardiac metastases rarely undergo surgical resection of metastatic tumors. However, emergent surgical resection of cardiac metastatic tumors should be considered to prevent sudden death.
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Maebayashi et al. (2020) conducted a case report in Cardiac metastasis from uterine leiomyosarcoma (n=1). Cardiac tumorectomy was evaluated on Patient survival and response to treatment. Emergent surgical resection of a right ventricular metastatic tumor from uterine leiomyosarcoma, followed by chemotherapy, prevented sudden death and resulted in a complete response.
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