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Chin Med J (Taipei) 1997;59:136-40.
1Division of Hematology, Department of Medicine; 2Division of Cardiovascular Surgery, Department of Surgery; and 3Department of Pathology, Veterans General Hospital-Taipei and 4National Yang-Ming University, Taipei, Taiwan, R.O.C.
Primary malignant cardiac tumors are uncommon, and cardiac leiomyosarcoma is extremely rare. We reported a case of left atrial (LA) leiomyosarcoma with unusual clinical manifestations. A 28-year-old female presented with unknown cause of fever, body weight loss and anemia for two months. Echocardiography and magnetic resonance image study disclosed a 5x3x3.6 cm3 lobulated mass in the LA with invasion to its posterior wall. Histologic and immuno-histochemical studies of the resected specimen revealed a picture of leiomyosarcoma. The patient improved after surgical resection and post-operative chemotherapy. The literature was reviewed with a discussion of the clinical manifestations, diagnosis and treatment strategy of this rare tumor. Diagnosis of LA leiomyosarcoma is frequently delayed to make a very poor prognosis. Postoperative chemotherapy should be considered because of highly possible incomplete resection. However, an optimal treatment regimen remains unknown.
[Chin Med J (Taipei) 1997;59:136-40.]
Keywords: fever of unknown origin, heart, left atrium, leiomyosarcoma
Received: June 12, 1996.
Accepted: October 19, 1996.
Address reprint requests to:
Hui-Chi Hsu, M.D.
Division of Hematology
Department of Medicine
Veterans General Hospital-Taipei
No. 20l, Sec. 2, Shih-Pai Road
Taipei, Taiwan, R.O.C.
Copyright: 1997, Chinese Medical Association (Taipei)