Case Report: Primary Pulmonary Angiosarcoma With Brain Metastasis

Abstract

Primary pulmonary angiosarcoma (PPA) is a rare malignant vascular tumor, of which early diagnosis is challenging due to lack of specific clinical manifestations and a low level of suspicion. Here, we report a case of PPA presented with advanced brain metastasis. A 21-year-old patient with 1 week history of headache and mild cough was hospitalized for a head injury. Head MRI showed multiple intracranial lesions with brain edema. Chest CT displayed bilateral pulmonary infiltrates with mediastinal lymph node enlargement. After 2 months of anti-tuberculosis treatment, the patient was readmitted for persistent headache and cough with occasional hemosputum along with worsening pulmonary and intracranial lesions. Despite seizure prophylaxis and control of intracranial pressure and brain edema, his symptoms progressively aggravated, accompanied by cough with bloody sputum, frequent epileptic seizures, and hypotension. He eventually developed coma and died within 3 months of onset of symptoms. An autopsy confirmed PPA with brain metastasis.

"Primary Pulmonary Angiosarcoma in 25-Year Old Patient"

“…Due to the various features of primary pulmonary angiosarcoma on CT scan, this can also be misinterpreted as an infection. Tang et al, have reported in a case that has been misdiagnosis due to the CT finding of left lower lobe ground-glass changes and lymphadenopathy especially with blood tests pointing toward that direction and their patient has been treated for tuberculosis Tang, et al [4]. PET is considered to be valuable to rule out widespread metastasis at presentation as well as for close follow-up throughout the treatment course (Wilson,et al [5]).…”