Complete regression of primary epicardial leiomyosarcoma with single agent doxorubicin in an elderly patient

Abstract

Soft tissue sarcomas are uncommon malignant mesenchymal neoplasms; however, they remain the second most frequent primary tumours of the heart. The most common of which is angiosarcoma, representing about 37% of cardiac sarcomas, whereas leiomyosarcoma is an extremely rare mesenchymal tumour of the heart and accounts for only 9% of all cardiac sarcomas.1 Nearly 75% of cardiac leiomyosarcomas originate from the atria and/or pulmonary vessels, with only 7.4% being epi/pericardial in origin.2 Dyspnoea, pericardial effusion, arrthythmia, syncope, chest pain, embolism, and fever are often encountered as presenting signs and symptoms of cardiac leiyomyosarcomas. Currently in literature, there are no wellestablished management guidelines for this, particularly in elderly patients. Surgical interventions may palliate symptoms related to obstruction and embolism, and may prolong survival.3,