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J Thorac Cardiovasc Surg 2005;129:694-695
© 2005 The American Association for Thoracic Surgery

Brief Communications

Extended right pneumonectomy with partial left atrial resection for primary leiomyosarcoma of the mediastinum

Massimiliano D'Aiuto, MDa, Giulia Veronesi, MDa, Giulio Pompilio, MDb, Roberto Gasparri, MDa, Fabio Presicci, MDa, Domenico Galetta, MDa, Paolo Biglioli, MDb, Lorenzo Spaggiari, MD, PhDa,*

a Division of Thoracic Surgery, European Institute of Oncology, Milan, Italy,
b Department of Cardiac Surgery, University of Milano, Centro Cardiologico-Fondazione I. Monzino, Milan, Italy

Received for publication May 29, 2004; revisions received June 30, 2004; accepted for publication July 21, 2004.

* Address for reprints: Lorenzo Spaggiari, MD, PhD, Division of Thoracic Surgery, European Institute of Oncology, Via Ripamonti, 435, 20141 Milan, Italy (E-mail: lorenzo.spaggiari@ieo.it).

The first 20% of the full text of this article appears below.

Primary leiomyosarcoma of the mediastinum is a rare malignancy that usually occurs either in the mesenchymal cells of the soft tissue of the visceral mediastinum or in the smooth muscle of the great vessels. The available data on this condition are minimal at best, but it seems that the most significant factor affecting survival is the ability to completely resect the mediastinal sarcoma.


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  		Arce, Tatani, Gasparri, Veronesi, Spaggiari, Presicci, Galetta, and D'Aiuto (left to right)

 
We report on a case of leiomyosarcoma of the mediastinum invading the left atrium and the right lung that was completely resected via a right pneumonectomy with en bloc partial resection of the left atrium.


   Clinical summary
 
A 62-year-old man was referred to our attention because a chest radiograph taken after 15 days of antibiotic therapy showed a persistent right lower pulmonary lobe infiltrate. This is an occasional finding during cardiovascular examinations performed to study recent single events of transient ischemic attack.

Workup included a full-body computed tomographic scan, which revealed a mediastinal mass of 6 cm in diameter extending to the right lower pulmonary lobe and to the inferior pulmonary vein, with extrinsic infiltration of the left atrium wall. The tumor presented an intravascular extension into the left atrial cavity via the inferior pulmonary . . . [Full Text of this Article]






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