Primary leiomyosarcoma of the right atrium presenting with a pulmonary embolism.

Primary Cardiac leiomyosarcoma is a very rare condition. The authors report the case of a 64 year old woman admitted to hospital for suspected pulmona ry embolism, confirmed by thoracic angio-CT scan. Despite thrombolytic ther apy. a persistent poor haemodynamic condition associated with a superior ve na cava syndrome led to a transoesophageal echocardiographic examination wh ich demonstrated an abnormal intra-right atrial mass obstructing the tricus pid valve. At surgery, a leiomyosarcoma was successfully resected under goo d conditions. During systematic three-monthly clinical and echocardiographic follow-up, t ransoesophageal echocardiography detected an asymptomatic local recurrence at 15 months, for which surgery was repeated with adjuvant chemotherapy.