[Pulmonary metastatic angiosarcoma presenting with diffuse alveolar hemorrhage: 9 case reports]

Area of Science:

• Oncology
• Pulmonary Medicine
• Cardiology

Background:

• Pulmonary metastatic angiosarcoma is a rare and aggressive malignancy.
• It often presents as diffuse alveolar hemorrhage (DAH), mimicking other lung conditions.
• Accurate and timely diagnosis is challenging due to its rarity and varied presentation.

Observation:

• A retrospective review of 9 patients with angiosarcoma presenting as DAH was conducted.
• All patients were male, with a median age of 41.
• Common symptoms included hemoptysis, dyspnea, and lower extremity edema; cardiac masses were frequent primary sites.

Findings:

• Chest CT revealed bilateral nodules and ground-glass opacities in all patients.
• Common misdiagnoses included tuberculosis and vasculitis.
• Surgical biopsy (lung or cardiac) was essential for diagnosis, as other methods were often inconclusive.

Implications:

• Metastatic pulmonary angiosarcoma should be suspected in DAH patients with characteristic CT findings.
• Proactive cardiologic monitoring is vital due to frequent cardiac involvement.
• Surgical biopsy remains the gold standard for definitive diagnosis, despite a poor median survival of 3 months post-surgery.