Issues in cardiovascular careAcute heart failure as manifestation of metastatic uterine leiomyosarcoma to the heart and lung
Introduction
Malignant tumors with a marked tendency to spread to the heart by the hematogenous route are malignant melanomas; carcinomas of kidney, lung, and breast; choriocarcinomas; and childhood rhabdomyosarcoma.1 Cardiac involvement with metastatic neoplasm is relatively uncommon. The most common malignancies encountered in order of decreasing frequency are lung, lymphoma, breast, leukemia, stomach, melanoma, liver, and colon.2 Uterine leiomyosarcoma is a rare soft tissue neoplasm comprising 1.3% of all uterine malignancies.3 Leiomyosarcoma accounts for less than 1% of tumors that metastasize to the heart.4 When this metastasis occurs, the metastatic tumor usually seeds in the right atrium and pulmonary artery.
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Case report
A 49-year-old female suffered sudden onset of orthopnea, dyspnea on exertion, and palpitation several times within few days and went to a local hospital. Her chest x-ray showed pulmonary edema and bilateral effusions (Figs. 1A and 1B). The laboratory data including thyroid functional test were limited in normal range except mild anemia (hematocrit: 31.8%). The arterial blood gas showed decreased oxygen saturation and mild respiratory alkalosis (pH: 7.465, PaO2: 54.7 mmHg, PaCO2: 34.7 mmHg).
Discussion
Uterine leiomyosarcoma is an uncommon malignant neoplasm that frequently metastasizes through the bloodstream to distant organs, such as the lung, bone, and brain. The morphologic and immunohistochemical appearance of the primary uterine tumor and the cardiopulmonary lesion in this patient strongly suggested that the uterine leiomyosarcoma metastasized to the heart and lung.
Initially, the patient presented as acute heart failure with pulmonary edema and bilateral pleural effusions. A tumor
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Cited by (10)
Extensive Cardiac Metastases Secondary to Uterine Leiomyosarcoma
2009, Journal of the American Society of EchocardiographySuccessful clinical approach to the metastatic uterine leiomyosarcoma to the epicardium—a case report
2024, BMC Cardiovascular DisordersSuccessful surgical treatment of cardiac metastasis from uterine leiomyosarcoma: A case report and literature review
2020, Journal of Obstetrics and Gynaecology ResearchCardiac metastasis of a uterine leiomyosarcoma
2019, Journal of Natural Science, Biology and MedicineMetastatic leiomyosarcoma presenting as a lung mass with left atrial extension: Case report and anesthetic management
2018, Therapeutics and Clinical Risk Management