Primary pulmonary sarcoma with left atrial extension via left superior pulmonary vein. En bloc resection and radical pneumonectomy on cardiopulmonary bypass.

A primary pulmonary sarcoma whose tumor stalk traversed the left superior pulmonary vein to occupy half of the left atrial cavity is reported. Because this extension was suspected and diagnosed preoperatively, appropriate surgical resection was possible. Had this extension not been recognized, an exploratory thoracotomy and division or manipulation of the pulmonary vein might have been undertaken, and systemic embolization might have occurred. By use of the median sternotomy approach and cardiopulmonary bypass, the tumor was removed en bloc through a combined left atrial resection and radical left pericardiopneumonectomy. A lung tumor invading the heart can be safely resected with the use of cardiopulmonary bypass if the extent of cardiac involvement is recognized preoperatively.