Pulmonary artery sarcoma mimicking pulmonary thromboembolism

Area of Science:

• Cardiovascular Pathology
• Thoracic Oncology
• Diagnostic Imaging

Background:

• Pulmonary thromboembolism (PTE) is a common diagnosis presenting with arterial occlusion.
• Pulmonary artery sarcomas are rare malignant tumors originating from the pulmonary artery lining.
• Misdiagnosis of pulmonary artery sarcoma as PTE is a significant clinical challenge.

Observation:

• A 30-year-old male presented with symptoms suggestive of PTE.
• Computed tomography (CT) angiography revealed a complete occlusion of the left main pulmonary artery, initially interpreted as a thrombus.
• Positron emission tomography-computed tomography (PET-CT) demonstrated abnormal uptake in the pulmonary artery mass, suggesting a neoplastic process.

Findings:

• Surgical resection (left pneumonectomy) was performed due to the tumor's location.
• Pathological examination confirmed the diagnosis of pulmonary artery sarcoma.
• This case highlights the potential for pulmonary artery sarcoma to mimic PTE on initial imaging.

Implications:

• Accurate and timely diagnosis of pulmonary artery sarcoma is crucial for appropriate treatment and patient outcomes.
• PET-CT imaging can be a valuable tool in the differential diagnosis of pulmonary artery masses, distinguishing them from thromboembolic events.
• Increased awareness and utilization of advanced imaging modalities may reduce misdiagnosis rates for this rare malignancy.