Difficulties in establishing a timely diagnosis of pulmonary artery sarcoma misdiagnosed as chronic thrombo-embolic pulmonary disease: a case report

Abstract

IntroductionPulmonary artery sarcomas are rare neoplasms that are often confused with chronic thrombo-embolic disease, as both can have similar clinical and imaging presentation.Case presentationIn this report, we present a case of a 50-year-old man initially diagnosed with chronic thrombo-embolic pulmonary disease, but who was later found to have pulmonary artery sarcoma with poor survival prognosis. We review the clinical and imaging characteristics of the two diseases and discuss the difficulties in establishing a timely diagnosis.ConclusionSimilar clinical features and imaging presentation of pulmonary artery sarcoma and chronic thrombo-embolic pulmonary disease make definitive diagnosis difficult. This case report also illustrates and emphasizes that in any case with no predisposition factors for embolism, no evidence of deep venous thrombosis and pulmonary emboli, and inadequate relief of symptoms with anticoagulation, an alternative diagnosis of pulmonary artery sarcoma should be considered. If pulmonary artery sarcoma is diagnosed late in the course of the disease, there is usually a poor survival outcome.

Primary pulmonary artery sarcoma: a close associate of pulmonary embolism—20-year observational analysis

“…We documented the histological patterns as reported. Nonetheless, in our study leiomyosarcoma was the most common histological type (20%) followed by spindle cell sarcoma; the two most frequent histopathology types described in the literature (2,15).…”

“…Primary pulmonary artery sarcoma: a close associate of pulmonary embolism-20-year observational analysis resonance angiography (MRA), or transesophageal echocardiography (TEE) ( Figure 1) (2). Aggressive, occlusive tumor growth within the PA predisposes to a poor prognosis, including right ventricular failure and sudden death.…”

From Pulmonary Artery Repair to Right Ventricular Outflow Tract Replacement

“…Use of TEE played a prominent role in establishing a PAS diagnosis in 2 other cases. 11,12 However, in these instances, TEE was used in the preoperative setting. Compared to other imaging modalities, TEE allows for the real-time characterization of the physiologic details of a lesion while simultaneously assessing ventricular and valvular function.…”

A Very Rare Cause of Anal Atresia: Currarino Syndrome

“…Presacral mass which accompanies CS may consist of a teratoma, a hamartoma, a neuroenteric cyst, anterior meningocele or a combination of these four entities [ 7 ]. Sacral agenesis is defined as partial or complete congenital absence of sacrum.…”