Combined surgical approach for sarcoma lung metastasis with atrial involvement

A 20-year-old patient, who had been treated for a femur sarcoma with pulmon ary metastases 8 years before, arrived at our institution with a new metast atic hilar lung nodule. During the standard lobectomy procedure an unexpect ed atrial invasion by the tumor was discovered. Intraoperative transesophag eal echocardiography (TEE) showed a big pediculated tumor in the atrium. Ca rdiopulmonary bypass (CPB) was required in order to safely resect the atria l wall with the tumor. The atrial defect was repaired with a pericardial pa tch. Postoperative course was uneventful. After 14 months, the patient is a symptomatic and free of disease.