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

子宮平滑肌肉瘤容易經由血路轉移，腹膜、腹腔及肺部是最常轉移的部位，而轉移至心臟則極罕見。我們報告一位急診病例以鬱血性心衰竭及急性肺水腫表現，經胸部心臟超音波發現一左心房腫塊佔據三分之二的左心房並阻礙了僧帽瓣血流，急診手術移除此腫塊並在手術中發現此腫塊是由右下肺靜脈延伸而來，病理報告證實此心內腫塊為轉移性平滑肌肉瘤。此病例是第一例被報告的肺部轉移性平滑肌肉瘤經肺靜脈侵犯左心房並以急性肺水腫表現。

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並列摘要

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. Abig 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 andmediastinal 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.

並列關鍵字

Metastatic pulmonary leiomyosarcoma ； Acute pulmonary edema ； Tumor invasion of pulmonary veins

國際替代計量

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

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