{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:50:36Z","timestamp":1753890636114,"version":"3.41.2"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:00:00Z","timestamp":1749513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>Leiomyosarcoma is frequently found in the retroperitoneum, mesentery, omentum, uterus, or subcutaneous tissue. However, primary cardiac leiomyosarcoma is rare and even more uncommon is its coexistence with a benign tumor. We report a case involving a 61-year-old female with a right ventricular outflow tract leiomyosarcoma in conjunction with a benign mass located in the main pulmonary artery. Echocardiography revealed a 2.5\u2009\u00d7\u20092.2\u2005cm isoechoic mass in the right ventricular outflow tract and a 3.8\u2009\u00d7\u20091.8\u2005cm irregular isoechoic mass in the main pulmonary artery. Computed tomography angiography (CTA) indicated a patchy filling defect in a similar location. Initially, pulmonary embolism was considered, however, the possibility of tumors could not be excluded. Given the high risk of mass embolization, we proceeded with emergency surgery. A large, irregular, solid mass was found attached to the wall of the main pulmonary artery, fortunately without involvement of the pulmonary valve. Exploration of the right ventricular outflow tract uncovered an additional solid, smooth, well-encapsulated mass. Immunohistochemical analysis of the right ventricular outflow tract mass confirmed the presence of tumor cells that were positive for Desmin and smooth muscle actin (SMA), while negative for S-100 and myoglobin, leading to a diagnosis of leiomyosarcoma. For the pulmonary mass, Immunohistochemistry revealed the proliferation of fibrous tissue, mucus degeneration, and calcification within the focal area. The imaging characteristics of cardiac leiomyosarcoma combined with benign pulmonary artery tumors may be misinterpreted as thrombosis, however, surgical resection remains a viable treatment option.<\/jats:p>","DOI":"10.3389\/fcvm.2025.1572673","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T05:22:14Z","timestamp":1749532934000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: A dual challenge: navigating cardiac leiomyosarcoma and benign pulmonary mass"],"prefix":"10.3389","volume":"12","author":[{"given":"Song","family":"Wu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiulin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jialiang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuankun","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shengjun","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutian","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"294","DOI":"10.21037\/qims.2019.11.13","article-title":"Cardiac magnetic resonance imaging of primary cardiac tumors","volume":"10","author":"Li","year":"2020","journal-title":"Quant Imaging Med Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"ivac081","DOI":"10.1093\/icvts\/ivac081","article-title":"Radical surgery for a mitral valve intimal sarcoma: serial patch repair of the annulus and atrium","volume":"35","author":"Matsuzaki","year":"2022","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.3390\/medicina58081009","article-title":"A rare case of undifferentiated pleomorphic cardiac sarcoma with inflammatory pattern","volume":"58","author":"Stoica","year":"2022","journal-title":"Medicina (Kaunas)"},{"key":"B4","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1001\/jamaoncol.2020.0086","article-title":"Cardiac masses in a patient with pancreatic adenocarcinoma and a history of breast carcinoma","volume":"6","author":"Nunnery","year":"2020","journal-title":"JAMA Oncol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"35","DOI":"10.3892\/mco.2021.2468","article-title":"Leiomyosarcoma of the splenic vein with a history of bilateral retinoblastoma: a case report and review of the literature","volume":"16","author":"Akabane","year":"2022","journal-title":"Mol Clin Oncol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2145","DOI":"10.2169\/internalmedicine.6965-15","article-title":"Primary cardiac leiomyosarcoma: a 27-month survival with surgery and chemotherapy","volume":"56","author":"Nakashima","year":"2017","journal-title":"Intern Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"220","DOI":"10.4103\/aca.aca_242_20","article-title":"Spindle-cell sarcoma of the heart: a case report of a rare cause of cardiac mass","volume":"25","author":"Badge","year":"2022","journal-title":"Ann Card Anaesth"},{"key":"B8","doi-asserted-by":"publisher","first-page":"84","DOI":"10.14503\/THIJ-14-4748","article-title":"Primary pulmonary valve leiomyosarcoma in a 35-year-old woman","volume":"43","author":"Vakilian","year":"2016","journal-title":"Tex Heart Inst J"},{"key":"B9","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1186\/s13019-024-02680-4","article-title":"Primary left ventricular leiomyosarcoma: a case report","volume":"19","author":"Balachandran","year":"2024","journal-title":"J Cardiothorac Surg"},{"key":"B10","first-page":"83","article-title":"A rare case of pulmonary leiomyosarcoma","volume":"55","author":"He","year":"2023","journal-title":"Acta Med Indones"},{"key":"B11","doi-asserted-by":"publisher","first-page":"2204","DOI":"10.1093\/eurheartj\/ehw173","article-title":"Leiomyoscarcoma in the right atrium","volume":"37","author":"Schneeweis","year":"2016","journal-title":"Eur Heart J"},{"key":"B12","doi-asserted-by":"publisher","first-page":"338","DOI":"10.4103\/aca.ACA_89_19","article-title":"Right ventricular outflow tract obstruction due to a leiomyosarcoma","volume":"23","author":"Suraci","year":"2020","journal-title":"Ann Card Anaesth"},{"key":"B13","doi-asserted-by":"publisher","first-page":"370","DOI":"10.2169\/internalmedicine.37.370","article-title":"Primary cardiac leiomyosarcoma growing rapidly and causing right ventricular outflow obstruction","volume":"37","author":"Esaki","year":"1998","journal-title":"Intern Med"},{"key":"B14","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1253\/circj.69.121","article-title":"Surgical treatment for primary cardiac leiomyosarcoma causing right ventricular outflow obstruction","volume":"69","author":"Ishikawa","year":"2005","journal-title":"Circ J"},{"key":"B15","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1007\/s10396-022-01280-w","article-title":"\u201cLife on the line\u201d: leiomyosarcoma causes right ventricular inflow tract obstruction","volume":"50","author":"Li","year":"2023","journal-title":"J Med Ultrason (2001)"},{"key":"B16","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1055\/s-2004-821276","article-title":"Leiomyosarcoma\u2013an unusual cause of right ventricular outflow tract obstruction","volume":"52","author":"Rastan","year":"2004","journal-title":"Thorac Cardiovasc Surg"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1335","DOI":"10.1016\/0002-8703(86)90375-3","article-title":"Primary right ventricular leiomyosarcoma producing outflow tract obstruction","volume":"112","author":"Talley","year":"1986","journal-title":"Am Heart J"},{"key":"B18","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1186\/1477-7819-12-338","article-title":"An uncommon long-term survival case of primary cardiac leiomyosarcoma","volume":"12","author":"Glaoui","year":"2014","journal-title":"World J Surg Oncol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e447","DOI":"10.1016\/j.jfo.2018.03.015","article-title":"Bilateral eyelid edema revealing a lung adenocarcinoma with superior vena cava syndrome: case report","volume":"41","author":"Duroi","year":"2018","journal-title":"J Fr Ophtalmol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1186\/s13019-017-0672-7","article-title":"Primary and metastatic cardiac tumors: echocardiographic diagnosis, treatment and prognosis in a 15-years single center study","volume":"12","author":"Nomoto","year":"2017","journal-title":"J Cardiothorac Surg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.1148\/radiographics.19.6.g99no031421","article-title":"CT and MR imaging of primary cardiac malignancies","volume":"19","author":"Araoz","year":"1999","journal-title":"Radiographics"},{"key":"B22","doi-asserted-by":"publisher","first-page":"17897","DOI":"10.1038\/s41598-018-36115-7","article-title":"Health risk stratification based on computed tomography pulmonary artery obstruction index for acute pulmonary embolism","volume":"8","author":"Guo","year":"2018","journal-title":"Sci Rep"},{"key":"B23","doi-asserted-by":"publisher","first-page":"200","DOI":"10.37616\/2212-5043.1344","article-title":"Leiomyosarcoma of the inferior vena cava extending to the right atrium and ventricle","volume":"35","author":"Alghasab","year":"2023","journal-title":"J Saudi Heart Assoc"},{"key":"B24","doi-asserted-by":"publisher","first-page":"6669","DOI":"10.4081\/rt.2017.6669","article-title":"Immunohistochemical diagnosis of primary cardiac leiomyosarcoma in a Latin American patient","volume":"9","author":"Blachman-Braun","year":"2017","journal-title":"Rare Tumors"},{"key":"B25","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1179\/1973947813Y.0000000080","article-title":"Complete regression of primary epicardial leiomyosarcoma with single agent doxorubicin in an elderly patient","volume":"25","author":"Karavelioglu","year":"2013","journal-title":"J Chemother"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.1080\/13543784.2017.1371134","article-title":"Aldoxorubicin for the treatment of soft tissue sarcoma","volume":"26","author":"Sachdev","year":"2017","journal-title":"Expert Opin Investig Drugs"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1272","DOI":"10.1001\/jamaoncol.2015.3101","article-title":"First-line aldoxorubicin vs doxorubicin in metastatic or locally advanced unresectable soft-tissue sarcoma: a phase 2b randomized clinical trial","volume":"1","author":"Chawla","year":"2015","journal-title":"JAMA Oncol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"5239","DOI":"10.1158\/1078-0432.CCR-18-0851","article-title":"Nilotinib as coadjuvant treatment with doxorubicin in patients with sarcomas: a phase I trial of the Spanish group for research on sarcoma","volume":"24","author":"Alemany","year":"2018","journal-title":"Clin Cancer Res"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1562","DOI":"10.3332\/ecancer.2023.1562","article-title":"Management of primary cardiac leiomyosarcoma","volume":"17","author":"Formigosa","year":"2023","journal-title":"Ecancermedicalscience"},{"key":"B30","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1186\/s12872-023-03689-8","article-title":"Successful clinical approach to the metastatic uterine leiomyosarcoma to the epicardium-a case report","volume":"24","author":"Krzelj","year":"2024","journal-title":"BMC Cardiovasc Disord"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1266","DOI":"10.1001\/jama.2020.1707","article-title":"Effect of doxorubicin plus olaratumab vs doxorubicin plus placebo on survival in patients with advanced soft tissue sarcomas: the ANNOUNCE randomized clinical trial","volume":"323","author":"Tap","year":"2020","journal-title":"JAMA"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1572673\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T05:22:16Z","timestamp":1749532936000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1572673\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,10]]},"references-count":31,"alternative-id":["10.3389\/fcvm.2025.1572673"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2025.1572673","relation":{},"ISSN":["2297-055X"],"issn-type":[{"type":"electronic","value":"2297-055X"}],"subject":[],"published":{"date-parts":[[2025,6,10]]},"article-number":"1572673"}}