Leiomyosarcoma Involving Main and Left Pulmonary Artery Treated Surgically With Homograft Replacement and Concomitant Left Pneumonectomy

A 47-year-old woman presented with progressive dyspnea on exertion and generalized weakness for 6 months. On physical examination, a grade-III ejection systolic murmur was heard on her upper sternal border. Her chest x-ray showed mild cardiomegaly with multiple, variable-sized nodular opacities in the right lung (Figure 1). Echocardiography revealed severe supravalvular pulmonary stenosis (peak and mean pressure gradient 76 mm Hg and 45.6 mm Hg, respectively) due to diffuse tubular supravalvular stenosis associated with increased right ventricular pressure (93.9 mm Hg) and left pulmonary artery narrowing. Multislice computed tomogram showed an intravascular mass lesion at the suprapulmonic valvular area, narrowing the lumen and extending …