Surgical resection of giant metastatic leiomyosarcoma of the heart.

A 44-year-old woman underwent a hysterectomy for leiomyosarcoma in 1969. Cardiac invasion was detected in 1981 but the tumor was considered inoperable. In 1985, 16 years after hysterectomy, malignant tamponade developed as a result of a massive tumor arising from the left ventricle. Emergency decompression by median sternotomy and tube thoracostomy was followed a week later by tumor resection and simultaneous excision of a lung metastasis with the aid of cardiopulmonary bypass. The cardiac tumor weighed 719 gm. A residual pelvic tumor found on a computed tomographic scan was subsequently removed. She is alive and well 22 months after the operation. Aggressive surgical resection of cardiac and other metastases of this slowly growing tumor can be lifesaving.