Left atrial leiomyosarcoma detected by spiral computed tomography and magnetic resonance imaging

We report a case of a 23-year-old man affected with dyspnea at rest, cough, and syncope. In the last year he showed recurrent upper right lobar pneumonia and, more recently, a cerebrovascular transient ischemic attack. Transthoracic echocardiography identified a large mass inside the left atrium, suspected as a myxoma. Spiral computed tomography and magnetic resonance imaging identified a malignant tumor involving the pulmonary veins. The patient died during surgery. Necropsy confirmed the presence of a highly malignant sarcoma in the left atrium, infiltrating the left atrial walls and extending to the pulmonary veins. At histological examination, diagnosis of a leiomyosarcoma was defined.