ABSTRACT
The authors report a case of left atrial leiomyosarcoma presenting with systemic disturbances and retinal emboli diagnosed by echocardiography and surgery in a 59 year old woman. Surgical ablation was completed by a course of chemotherapy. Histopathological examination confirmed the diagnosis of sarcoma; although the patient remained generally well, severe mitral regurgitation appeared 21 months after surgery. Transoesophageal echocardiography revealed an abnormal, hyper-mobile, intra-atrial echo suggesting a ruptured chordae tendinae and the mitral valves appeared very thickened and retracted. The patient was reoperated and the mitral valve replaced with a bioprosthesis. After a total follow-up of 29 months, the patients is still alive and asymptomatic. The authors underline the importance of echocardiography in the diagnosis of intra-cardiac tumours in general and, in particular, of intra-cardiac sarcomas.