Recurrent left-sided heart leiomyosarcoma: Should heart transplantation belegitimate?

Leiomyosarcoma of the heart is an uncommon primary malignant tumor with poo r postoperative survival that may be measured in months. A leiomyosarcoma o f the left atrium was diagnosed in a 47-year-old man. Initial admission was for acute pulmonary edema requiring emergency surgery. The tumor involved the left atrial cavity, and a radical resection was performed. Six months l ater an isolated myxomatous recurrence was detected. Heart transplantation was then performed. The patient is in good health 20 months after operation with no evidence of residual disease or recurrence. The Literature has bee n reviewed. Surgical resection is not an adequate treatment for leiomyosarc oma of the left atrium and early heart transplantation probably offers the only hope for these patients.