[A case of pulmonary rupture with primary pulmonary leiomyosarcoma--management by emergency surgical intervention]

We report a case of 18-year-old boy who was admitted to our hospital for hemoptysis and hemothorax caused by rupture in the pulmonary tissue. A tumoral mass was found protruding from the inferior aspect of the left lower lobe towards the diaphragma. A large hematoma was seen in the vicinity of the tumoral mass. An emergency left lower lobectomy was performed and the hematoma was removed. The tumor was yellow in color, soft and 7 cm in diameter. The histological diagnosis was that of primary pulmonary leiomyosarcoma. The resected lobe had a liver-like hard consistency due to extended infiltration of blood resulting from hemorrhages within the tissue located in and around the tumoral mass. Microscopically, the tumor was composed of the spindle-shaped cells with multinucleation along with some clear cell patterns. Recurrence of the tumor appeared six months after the operation, and a second resection of the recurrent leiomyosarcomatous tissue was performed. The patient is still alive for 1 year and 6 months after the first operation.