Pulmonary Metastatic Leiomyosarcoma with Left Atrial Extension via the Pulmonary Vein Manifests as Acute Pulmonary Edema

We report a case who presented to our emergency department with symptoms of congestive heart failure and acute pulmonary edema. The transthoracic echocardiography demonstrated a large tumor that occupied two-thirds of the left atrium and impeded the mitral valve flow. The patient underwent cardiac surgery with removal of the LA tumor that was intraoperatively found extending through the right inferior pulmonary vein. A big tumor mass over the right lower lobe of the lung was also disclosed. The pathological report of the left atrial tumor was metastatic leiomyosarcoma. Postoperative survey showed multiple metastatic tumors over the lung, liver, bones and mediastinal lymph nodes. The symptoms and signs of congestive heart failure improved after the surgery. The patient had history of uterine leiomyosarcoma and received debulking surgery with postoperative radiotherapy 9 years prior to this hospitalization. This is the first report of a pulmonary metastatic leiomyosarcoma reaching the left atrium by way of the pulmonary veins and manifested as acute pulmonary edema.