Case Report: A dual challenge: navigating cardiac leiomyosarcoma and benign pulmonary mass

Leiomyosarcoma is frequently found in the retroperitoneum, mesentery, omentum, uterus, or subcutaneous tissue. However, primary cardiac leiomyosarcoma is rare and even more uncommon is its coexistence with a benign tumor. We report a case involving a 61-year-old female with a right ventricular outfl...

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Main Authors: Song Wu, Qiulin Chen, Yi Yang, Jialiang Liu, Yuankun Li, Shengjun Cheng, Yutian Wu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1572673/full
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author Song Wu
Qiulin Chen
Yi Yang
Jialiang Liu
Yuankun Li
Shengjun Cheng
Yutian Wu
author_facet Song Wu
Qiulin Chen
Yi Yang
Jialiang Liu
Yuankun Li
Shengjun Cheng
Yutian Wu
author_sort Song Wu
collection DOAJ
description Leiomyosarcoma is frequently found in the retroperitoneum, mesentery, omentum, uterus, or subcutaneous tissue. However, primary cardiac leiomyosarcoma is rare and even more uncommon is its coexistence with a benign tumor. We report a case involving a 61-year-old female with a right ventricular outflow tract leiomyosarcoma in conjunction with a benign mass located in the main pulmonary artery. Echocardiography revealed a 2.5 × 2.2 cm isoechoic mass in the right ventricular outflow tract and a 3.8 × 1.8 cm irregular isoechoic mass in the main pulmonary artery. Computed tomography angiography (CTA) indicated a patchy filling defect in a similar location. Initially, pulmonary embolism was considered, however, the possibility of tumors could not be excluded. Given the high risk of mass embolization, we proceeded with emergency surgery. A large, irregular, solid mass was found attached to the wall of the main pulmonary artery, fortunately without involvement of the pulmonary valve. Exploration of the right ventricular outflow tract uncovered an additional solid, smooth, well-encapsulated mass. Immunohistochemical analysis of the right ventricular outflow tract mass confirmed the presence of tumor cells that were positive for Desmin and smooth muscle actin (SMA), while negative for S-100 and myoglobin, leading to a diagnosis of leiomyosarcoma. For the pulmonary mass, Immunohistochemistry revealed the proliferation of fibrous tissue, mucus degeneration, and calcification within the focal area. The imaging characteristics of cardiac leiomyosarcoma combined with benign pulmonary artery tumors may be misinterpreted as thrombosis, however, surgical resection remains a viable treatment option.
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spelling doaj-art-058e0729363e4d24afb4fd69ff11fe402025-08-20T02:08:57ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-06-011210.3389/fcvm.2025.15726731572673Case Report: A dual challenge: navigating cardiac leiomyosarcoma and benign pulmonary massSong WuQiulin ChenYi YangJialiang LiuYuankun LiShengjun ChengYutian WuLeiomyosarcoma is frequently found in the retroperitoneum, mesentery, omentum, uterus, or subcutaneous tissue. However, primary cardiac leiomyosarcoma is rare and even more uncommon is its coexistence with a benign tumor. We report a case involving a 61-year-old female with a right ventricular outflow tract leiomyosarcoma in conjunction with a benign mass located in the main pulmonary artery. Echocardiography revealed a 2.5 × 2.2 cm isoechoic mass in the right ventricular outflow tract and a 3.8 × 1.8 cm irregular isoechoic mass in the main pulmonary artery. Computed tomography angiography (CTA) indicated a patchy filling defect in a similar location. Initially, pulmonary embolism was considered, however, the possibility of tumors could not be excluded. Given the high risk of mass embolization, we proceeded with emergency surgery. A large, irregular, solid mass was found attached to the wall of the main pulmonary artery, fortunately without involvement of the pulmonary valve. Exploration of the right ventricular outflow tract uncovered an additional solid, smooth, well-encapsulated mass. Immunohistochemical analysis of the right ventricular outflow tract mass confirmed the presence of tumor cells that were positive for Desmin and smooth muscle actin (SMA), while negative for S-100 and myoglobin, leading to a diagnosis of leiomyosarcoma. For the pulmonary mass, Immunohistochemistry revealed the proliferation of fibrous tissue, mucus degeneration, and calcification within the focal area. The imaging characteristics of cardiac leiomyosarcoma combined with benign pulmonary artery tumors may be misinterpreted as thrombosis, however, surgical resection remains a viable treatment option.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1572673/fullcarcinomacase reportprimary leiomyosarcomabenign tumorcardiac tumor
spellingShingle Song Wu
Qiulin Chen
Yi Yang
Jialiang Liu
Yuankun Li
Shengjun Cheng
Yutian Wu
Case Report: A dual challenge: navigating cardiac leiomyosarcoma and benign pulmonary mass
Frontiers in Cardiovascular Medicine
carcinoma
case report
primary leiomyosarcoma
benign tumor
cardiac tumor
title Case Report: A dual challenge: navigating cardiac leiomyosarcoma and benign pulmonary mass
title_full Case Report: A dual challenge: navigating cardiac leiomyosarcoma and benign pulmonary mass
title_fullStr Case Report: A dual challenge: navigating cardiac leiomyosarcoma and benign pulmonary mass
title_full_unstemmed Case Report: A dual challenge: navigating cardiac leiomyosarcoma and benign pulmonary mass
title_short Case Report: A dual challenge: navigating cardiac leiomyosarcoma and benign pulmonary mass
title_sort case report a dual challenge navigating cardiac leiomyosarcoma and benign pulmonary mass
topic carcinoma
case report
primary leiomyosarcoma
benign tumor
cardiac tumor
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1572673/full
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