A Primary Left Atrial Leiomyosarcoma Mimicking Myxoma: Echocardiographic Findings

Abstract

Echocardiography is the initial imaging modality to delineate the cardiac mass. Clinically echocardiographic information about morphology, location, motion and hemodynamic consequences of the tumor is very important for decision making in terms of additional imaging studies and treatment. We present a case of left atrial leiomyosarcoma masquerading as myxoma preoperatively and discuss the echocardiographic features for distinguishing leiomyosarcoma from a benign tumor, such as myxoma.

Primary cardiac leiomyosarcoma: An analysis of clinical characteristics and outcome patterns

“…Sometimes, the tumor may be misdiagnosed as cardiac myxoma by the imaging examinations. 20,43,44 Positron-emission tomography was documented in 3 case, of which 1 was missed. 23…”

Recurrence of Cardiac Leiomyosarcoma After Three Months: A Case Study

“…This is especially true when it is located in the left atrium. The tumor may be misdiagnosed as cardiac myxoma by echocardiography (4,5). In our case, myxoma was also the first diagnosis.…”

“…The findings for malignancy are immobile mass, pericardial effusion, broad base of the tumor, and neovascularity (4). Cardiac magnetic resonance imaging is recommended for additional structured and functional assessment of most reported misdiagnosis (5).…”

A Primary Right Atrial Leiomyosarcoma in a 59-Year-Old Female Patient

“…1 Fewer than 50 cases of cardiac leiomyosarcomas are reported in the literature. [1][2][3][4][5][6][7][8][9] Leiomyosarcoma typically occurs in the fourth decade of life, slightly earlier than the mean age of patients with cardiac sarcoma. 3 Leiomyosarcoma is a mesenchymal tumor originating from smooth muscle cells.…”

“…Among these findings, tumor immobility, presence of pericardial effusion, broad-based tumor and neovascularity are in favor of malignancy. 8 In cases where imaging methods are insufficient, definitive histological diagnosis of the tumor with preoperative transvenous or percutaneous biopsy allows tumor-specific treatment planning. 7 In our case, the TEE report was a mass compatible with myxoma in the foreground in the right atrium, however the differential diagnosis of myxoma from sarcoma could not be made.…”