Primary left atrial leiomyosarcoma simulating pulmonary thromboembolism

The authors describe a patient with primary left atrial leiomyosarcoma extending into the right pulmonary veins. The initial presentation and ventilation-perfusion scanning suggested pulmonary thromboembolism. The results of transthoracic echocardiography were nondiagnostic, and the diagnosis was eventually made on the basis of computed tomography (CT) and transesophageal echocardiography findings. The diagnosis was confirmed at surgery. This case demonstrates the complementary roles of CT and transesophageal echocardiography in the evaluation of intracardiac masses when transthoracic echocardiography is nondiagnostic. It also illustrates that cardiac tumours may present with nonspecific symptoms that mimic those of other disease.