<b>Medical Journal Article Annotated Citations</b>

<b>Latest Pubmed/Medline Search for Leiomyosarcoma &&url   </b>


Can J Cardiol 2001 Mar;17(3):331-6 
<b>Myxoid leiomyosarcoma of the left atrium: a rare malignancy of the heart and its comparison with atrial myxoma. </b>
Morin JE, Rahal DP, Huttner I. Department of Cardiothoracic Surgery, McGill University Health Centre and Royal Victoria Hospital, Montreal, Canada. jean.morin@muhc.mcgill.ca 

Primary tumours of the heart are rare. The majority of these tumours are benign, with myxomas located in the left atrium being the most common form. Almost all malignant tumours are sarcomas and occur preferentially in the right side of the heart. An exception to this rule is leiomyosarcoma, a rare form of primary cardiac sarcoma that occurs predominantly in the left atrium, as does cardiac myxoma. The case of a 53-year-old woman who presented with symptoms of mitral valve stenosis and pulmonary hypertension is reported. Cardiac catheterization, angiography and echocardiography revealed a left atrial mass that was interpreted as atrial myxoma. ,,, The tumour, including a wide rim of atrial septum, was removed with cautery. Histopathological examination unexpectedly showed that the tumour was not an atrial myxoma but rather a myxoid variant of a primary leiomyosarcoma. Immunohistochemistry and electron microscopy confirmed the diagnosis. Local radiotherapy was considered but deemed contraindicated in view of the longstanding pulmonary hypertension. Two months after excision, a repeat echocardiogram indicated recurrence of tumour in the left atrium, and the patient died a few days later. The preferential left atrial location and the frequently myxoid appearance of primary leiomyosarcomas of the heart make it particularly difficult to differentiate them preoperatively from atrial myxomas. The authors recommend resection of all atrial myxoid tumours with a wide (at least 1 cm) margin, combined with intraoperative frozen section diagnosis, because <b>complete surgical resection appears to correlate with prolonged survival in the few reported cases of atrial leiomyosarcomas.</b>  In cases of incomplete initial resection or local recurrence in the absence of metastatic disease, heart transplantation may be a valid option in appropriately selected patients. 

&&url PMID: 11264566 


Cardiologia 1999 Nov;44(11):1001-3 
<b>Left ventricular metastasis from uterine leiomyosarcoma. </b>
Cordioli E, Pizzi C, Bugiardini R. Dipartimento di Medicina Interna, Cardioangiologia, Epatologia, Universita degli Studi, Bologna. 

<b>Cardiac metastases are uncommon but seem to be increasing in incidence, possibly in relation to prolonged survival of cancer patients</b>. Leiomyosarcoma metastatic to the heart is extremely rare. We report the case of a 57-year-old woman previously treated for uterine leiomyosarcoma who presented with dyspnea, electrocardiographic changes mimicking myocardial infarction, and normal enzymes. A left intraventricular mass, suspected as cardiac metastasis, was revealed by echocardiography. The patient died 1 week later. At autopsy the mass proved to be histologically a metastasis of the uterine tumor. 

&&url PMID: 10686777


Int J Cardiol 1997 Jun 27;60(1):91-4 
<b>Primary cardiac leiomyosarcoma: seven-year survival with combined surgical and adjuvant therapy. </b>
Pessotto R, Silvestre G, Luciani GB, Anselmi M, Pasini F, Santini F, Mazzucco A. Division of Cardiac Surgery, OCM B.go Trento, Verona, Italy. 

Primary cardiac sarcomas constitute a rare entity that has been uniformly associated with poor long-term survival. A case of left atrial leiomyosarcoma involving the interatrial septum and the right atrial free wall and presenting with syncope and atrial fibrillation, is described. <b>Two extensive surgical excisions followed by adjuvant radiation and chemotherapy improved survival with a good quality of life. This approach of combined surgical, medical and radiation therapy may offer better longterm outcome, since our patient is the longest survivor thus far reported.</b>   

&&url PMID: 9209944 


Cancer 1992 Jan 15;69(2):387-95 
<b>Primary sarcomas of the heart. </b>
Burke AP, Cowan D, Virmani R. Department of Cardiovascular Pathology, Armed Forces Institute of Pathology, Washington, D.C. 20306-6000. 

Seventy-five primary sarcomas of the heart were classified by histologic appearance as,,, leiomyosarcoma (4 cases,,, The ages of the patients ranged from 1 to 75 years at the time of presentation (mean, 39 years). Angiosarcomas were predominantly right-sided and osteosarcomas left-sided. Forty patients treated surgically were examined, and survival correlated with clinical and histologic parameters. the survival rate was poor, with a mean of 11 months and median of 6 months. By univariate analysis, the survival rate was more favorable for patients with tumors located on the left side of the heart, without necrosis, with a low mitotic count, and without metastasis at diagnosis. <b>Survival rates were better in patients receiving chemotherapy and radiation therapy.[BUT this was a mixed group of sarcomas, not leiomyosarcoma alone.  Ed.]</b>Age, gender, presence of differentiation, and histologic type did not affect prognosis. By multivariate analysis, a low level of mitotic activity and any therapy were the only significant factors affecting survival rate,,,  

&&url PMID: 1728367
