We report a 43-year-old female with the underlying disease of retroperitoneal leiomyosarcoma and initial presentation of ST elevation myocardial infarction. Coronary angiography showed an absence of coronary artery stenosis and a huge, ill-defined cardiac mass which was fed by both the left anterior descending artery and the right coronary artery. Coronary blood flow was obviously shunted by the neovascularized cardiac tumor. Right ventricle metastatic leiomyosarcoma was diagnosed according to her clinical course, images of echocardiography and computed tomography. In conclusion, we speculated that ST-segment elevation in electrocardiogram and typical anginal symptoms can provide significant evidence for myocardial ischemia caused by coronary steal phenomenon due to a right ventricular metastatic leiomyosarcoma.
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