title: [Pulmonary vein leiomyosarcoma extending into the left atrium].
abstract: In this paper, the authors report the case of a 28-year-old man with pulmonary vein leiomyosarcoma presenting subacute respiratory distress. Thoracic computed tomography and transoesophagal ultrasonographic examination of the heart suggested the diagnosis of a heart tumour revealed by the obstruction of the mitral valve and pulmonary oedema. Emergency cardiac surgery revealed the mass to be a leiomyosarcoma, probably extending from the right inferior pulmonary vein and extending into the left atrium. The clinical evolution was complicated because of a sudden local relapse. The patient underwent a second cardiac intervention involving lower right lobectomy followed by adjuvant chemotherapy with an ifosfamide-adriamycin combination. This treatment failed to control the disease and a third cardiac intervention was necessary with second-line gemcitabine-paclitaxel adjuvant chemotherapy. Further recurrences were observed with metastases first in the scalp and then in the spine and adrenal glands leading to the death of the patient 2 years after the diagnosis.
authors.affiliation: Service de cardiologie et de médecine aéronautique, hôpital d'instruction des armées Percy, Clamart, France. marie.garraud@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Garraud
authors.forename: J
authors.initials: J
authors.lastname: Margery
authors.forename: F
authors.initials: F
authors.lastname: Laborde
authors.forename: P
authors.initials: P
authors.lastname: Saint-Blancard
authors.forename: S
authors.initials: S
authors.lastname: David
authors.forename: G
authors.initials: G
authors.lastname: Bonardel
authors.forename: P
authors.initials: P
authors.lastname: Héno
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D017548:Echocardiography, Transesophageal; D017809:Fatal Outcome; D006325:Heart Atria / Q000473:pathology*; D006338:Heart Neoplasms / Q000473:pathology*; D006801:Humans; D007890:Leiomyosarcoma / Q000175:diagnosis*; D008297:Male; D008889:Military Personnel; D008943:Mitral Valve / Q000473:pathology; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D011654:Pulmonary Edema / Q000175:diagnosis; D011667:Pulmonary Veins / Q000473:pathology*; D012131:Respiratory Insufficiency / Q000175:diagnosis; D014057:Tomography, X-Ray Computed; D019043:Vascular Neoplasms / Q000175:diagnosis*