Pleural Myiasis Associated With Pleural Angiosarcoma

Patel, Mitesh; Munzer, Kurt; Dougherty, Mary Ellen; Williams, Peter; Loiselle, Andrea

doi:10.1016/j.chest.2015.12.022

Cited by 6 publications

(7 citation statements)

References 9 publications

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“…Biopsy or tumor resection performed by thoracotomy or by video-assisted thoracoscopic surgery were by far the most frequently applied and helpful diagnostic tool for PPA. [ 16 , 17 ] Percutaneous lung/pleural biopsy was also supported by some cases. [ 13 , 18 , 19 ] Pleural cytology had negative findings in all cases of PPA.…”

Section: Discussionmentioning

confidence: 97%

Primary pleural epithelioid angiosarcoma treated successfully with anti-PD-1 therapy

et al. 2021

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Rationale: Primary pleural angiosarcoma (PPA) is an extremely rare malignancy for which there is no consensus on treatment. The clinical course of PPA is usually quickly fatal, regardless of the treatment used. Patient concerns: We describe the rare case of a 52-year-old man who presented initially with hemoptysis and received emergency surgery for the primary. Diagnoses: He received a confirmed diagnosis of primary pleural angiosarcoma (PPA) by postoperative pathology and was subsequently treated with radiotherapy and chemotherapy, but had failed and was intolerant to chemotherapy. Interventions: The patient had 5% tumor PD-L1 positivity with 22C3 pharmDx and received pembrolizumab (200 mg every 21 days) for 13 cycles. Outcomes: The disease remained well controlled according to the RECIST 1.1. criteria. He is currently under observation and waiting to start the next cycle of immunotherapy. Lesson: Our case report suggests that the use of anti-PD-1 therapy does show efficacy in the treatment of PPA and may provide a viable treatment option for patients.

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Section: Discussionmentioning

confidence: 97%

Primary pleural epithelioid angiosarcoma treated successfully with anti-PD-1 therapy

et al. 2021

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“…The pathogenesis and etiology are still obscure. PPA has been described in the setting of chronic tuberculous pyothorax, foreign bodies, viral or other infection, empyema, asbestosis exposure, trauma (surgical excision), as well as a long-term consequence of radiotherapy, and even without any prior history as de novo tumors [ 3 , 4 , 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

Multidetector CT findings of primary pleural angiosarcoma : a systematic review, an additional cases report

et al. 2022

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Background To demonstrate and analyze the relatively common imaging findings in this rare primary pleural angiosarcoma (PPA). Case presentation Three cases of PPA, proven by video-assisted thoracic surgery biopsies are retrospectively reviewed. Patients were all male. Age ranges from 65 to 75 years old age (mean; 69). Major chief complaints were dyspnea and chest pain. One has a history of colon cancer, the other has a tuberculosis history and the other has no known history. Multidetector chest CT and PET CT were all done. Immunohistochemical studies were performed including CD31, CD34, or factor VIII-related antigen, vimentin, and cytokeratin. We also review the literatures on recently published PPA. All masses were from 1 to 10 cm. All three patients had multiple pleural based masses, which were ovoid in shape with relatively sharp margin in unilateral hemithorax. Multiple small circumscribed pleural masses are limited in the pleural space in two patients, whereas two, huge lobulated masses about up to 10 cm were present with pleural and extrapleural involvement in one patient. In two patients with pleural mass only, multiple pleural masses were only seen in parietal pleura in one patient and were in both visceral and parietal pleura in one patient. Pleural effusion were found in one side in one patient and in both sides in one patient. One angiosarcoma was arised from chronic tuberculotic pleurisy sequelae. All pleural masses are heterogenous with irregular internal low densities in all patients. Hematogenous metastases were found in liver, vertebra, rib in one patient, and were in lungs with mediastinal lymph node metastases in the other patient. Three patients survived for longer than 3months after diagnosis, but continued to deteriorate rapidly. Two patients underwent chemotherapy after surgical excision, and the other one with multiple metastases treated chemotherapy after CT-guided biopsy, but eventually all died. As a result of comparative analysis of a total of 13 patients’ images including 10 cases previously published, there was pleural effusion in all except 2 cases. Conclusions PPA were all necrotic without any vascularized enhancing nature, and manifested as unilateral circumscribed or localized pleural-based masses.

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“…Patel et al have reported a case of pleural myiasis in a patient with pleural angiosarcoma. [10] ey hypothesized that abundant necrosis in angiosarcoma, poor living conditions and less than ideal wound care might have attracted flies which then laid eggs near the thoracostomy tube insertion site. ey postulated that larvae might have then migrated to the pleural space.…”

Section: Discussionmentioning

confidence: 99%

“…Although their patient had initially presented with polymicrobial empyema and malodour from the thoracostomy tube, myiasis was clinically diagnosed after another 4 days by identification of apparent larvae in the thoracostomy tube and water seal drainage system. [ 10 ] The presence of malodourous secretions has been suggested as a clue to myiasis infestation. [ 2 ] Maggots in the ICD chamber was a serendipitous finding in our case with the patient neither having any purulent discharge nor malodour from the ICD.…”

Section: Discussionmentioning

confidence: 99%

Maggots in the Intercostal Drain: Case Report of a Rare Presentation with a Brief Review of Literature

Gupta

Rao

Salins

et al. 2021

IJPC

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Maggots are dipterous larvae of flies. Infestation of vertebrate animals (including humans) by maggots is termed as Myiasis. Warm and Humid climate, low socio-economic status, lack of knowledge and poor living conditions, malignant wounds predispose the cancer patients to maggot infestation in India. Apart from infestation in the wounds; oral, ophthalmic, nasal, aural, enteric, urogenital, trachea-pulmonary and rectal myiasis have been reported. Maggot infestation of the Intercostal drain (ICD) container without associated pleural myiasis is an extremely rare entity. We describe a rare case report of maggots in the ICD in a patient with metastatic chondrosarcoma femur with ICD in situ for malignant pleural effusion. Early detection and management are the keys to prevent the catastrophic complication of pleural myiasis.

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Pleural Myiasis Associated With Pleural Angiosarcoma

Cited by 6 publications

References 9 publications

Primary pleural epithelioid angiosarcoma treated successfully with anti-PD-1 therapy

Primary pleural epithelioid angiosarcoma treated successfully with anti-PD-1 therapy

Multidetector CT findings of primary pleural angiosarcoma : a systematic review, an additional cases report

Maggots in the Intercostal Drain: Case Report of a Rare Presentation with a Brief Review of Literature

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