Tortorelli Ilaria, Navarria Federico, Maggio Antonio Di, Banzato Alberto, Lestuzzi Chiara, Nicosia Luca, Chiusole Benedetta, Galiano Antonella, Sbaraglia Marta, Zagonel Vittorina, Brunello Antonella
Oncology 1 Unit, Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.
Radiation Oncology Department, National Cancer Institute (CRO)- IRCCS, Aviano, Italy.
Front Oncol. 2022 Apr 28;12:838114. doi: 10.3389/fonc.2022.838114. eCollection 2022.
Leiomyosarcoma (LMS) is one of the most frequent subtypes of soft-tissue sarcomas (STSs). Metastatic spread to the heart in cancer patients carries a poor prognosis and there is no known effective treatment. Cardiac metastases of STSs are very rare. Here we present the case of a 55-year-old patient who underwent surgical resection of a retroperitoneal leiomyosarcoma and then developed widespread metastatic disease, treated with a combination of local treatment and systemic therapy. Three years after surgical resection she presented with a cardiac intraventricular mass, which was treated with radiation therapy, while receiving systemic therapy with trabectedin. Such combination therapy was well-tolerated and effective, allowing a substantial dimensional reduction which is perduring to date, 18 months after diagnosis of cardiac metastasis. Available literature and data point to the feasibility and good tolerability of radiation therapy and trabectedin in metastatic sarcoma, yet this is the first report on the effectiveness of the combination for the treatment of cardiac disease. The extended survival since a metastatic relapse (more than 3 years) is likely the result of integrated systemic and loco-regional treatment, which should be always discussed within the framework of a multiprofessional and multidisciplinary setting.
平滑肌肉瘤（LMS）是软组织肉瘤（STS）最常见的亚型之一。癌症患者发生心脏转移预后较差，且尚无已知的有效治疗方法。STS的心脏转移非常罕见。在此，我们报告一例55岁患者，该患者接受了腹膜后平滑肌肉瘤手术切除，随后发生广泛转移，接受了局部治疗和全身治疗相结合的方案。手术切除三年后，她出现心脏室内肿块，接受了放射治疗，同时接受曲贝替定全身治疗。这种联合治疗耐受性良好且有效，使肿块大幅缩小，自心脏转移诊断后18个月至今仍持续有效。现有文献和数据表明放射治疗和曲贝替定在转移性肉瘤中具有可行性和良好的耐受性，但这是关于该联合治疗对心脏病有效性的首次报告。自转移复发以来延长的生存期（超过3年）可能是全身和局部区域综合治疗的结果，应始终在多专业和多学科的背景下进行讨论。
