title: Unusual cardiac metastasis of uterine leiomyosarcoma: case report and literature review.
abstract: BACKGROUND
  Uterine leiomyosarcoma (LMS) is a rare malignancy of mesenchymal tissues and in advanced stages its prognosis is very poor. Surgery followed by radiotherapy and/or chemotherapy is the treatment of choice for advanced disease. Cardiac metastases are very uncommon and only a few cases have been described to date.
  
  
  METHODS
  A 55-year-old woman was referred to our center for a uterine LMS with lung metastases at diagnosis. After 3 lines of chemotherapy for persistent lung disease, CT scan showed suspected thrombosis in the right pulmonary vein, along with disease progression in the lungs. The patient started treatment with low-molecular-weight heparin and a fourth line of chemotherapy. After 3 months of therapy, a new CT scan showed a larger thrombus and she underwent a cardiology visit that revealed an intracardiac mass. Submitting the patient to palliative surgery or radiation therapy was not possible because of the aggressiveness of the lung metastases, so she continued chemotherapy, resulting in disease stabilization.
  
  
  CONCLUSIONS
  Surgery is the best option for intracardiac dissemination of uterine LMS, but when this is not possible based on the performance status of the patient and spread of the disease, the combination of chemotherapy and radiotherapy seems to be the best option according to the literature. In our case we treated the patient only with chemotherapy.
authors.affiliation:  Oncohematology Unit, Medical Science Department, ULSS 13, Mirano (Venice) - Italy.
authors.forename: Grazia
authors.initials: G
authors.lastname: Artioli
authors.affiliation:  Oncohematology Unit, Medical Science Department, ULSS 13, Mirano (Venice) - Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Borgato
authors.affiliation:  Cardiology Department, ULSS 13, Mirano (Venice) - Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Calamelli
authors.affiliation:  Oncohematology Unit, Medical Science Department, ULSS 13, Mirano (Venice) - Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Azzarello
mesh_terms: D003131:Combined Modality Therapy; D004452:Echocardiography; D005260:Female; D006338:Heart Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000556:secondary*; D006801:Humans; D007890:Leiomyosarcoma / Q000175:diagnosis / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009367:Neoplasm Staging; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy