Intimal sarcoma in 4 Months: a case report HuA-MiN CHENg ANDy SHAuN-BiN CHou Kuo-HSiEN CHiANg yuNg-HSiANg HSu PAu-yANg CHANg
نویسنده
چکیده
Intimal sarcoma of pulmonary artery is a disease easily misdiagnosed as acute or chronic pulmonary thromboembolism. Although the disease is rarely seen, life-saving surgical treatment can be applied if correctly diagnosed. We report a case of 69-year-old woman with clinical presentation of progressive dyspnea received medical treatment because pulmonary embol ism was initially diagnosed. But CT study 4 months later showed progression and contrast enhancement of the supposed pulmonary “thromboembolism”. Endarterectomy was performed and pathology showed intimal sarcoma. The patient expired 4 days after operation due to hepatic failure which was considered to be resulted from chronic pulmonary hypertension exacerbating due to circulatory arrest for 3 times with intermittent reperfusion during the surgery. This report provides the diagnostic value of CT study with the enhancement of tumor and expansile appearance of interlobar arteries. Since Mandelstamm’s first description in 1923, there have been more than 200 cases of pulmonary arterial sarcoma reported in the English literature. Most tumors appear as filling defects in the pulmonary artery or its tributaries on enhanced computed tomography (CT) scans [1]. Because of its rarity pulmonary arterial sarcoma is often misdiagnosed as chronic pulmonary thromboembolism and results in delayed surgical treatment, lower survival rate and poor prognosis. Computed tomography is useful to detect pulmonary arterial intimal sarcoma. We report a case with intimal sarcoma of pulmonary artery and its serial CT findings.
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