Pulmonary artery sarcoma masquerading as a pulmonary embolism

Area of Science:

• Cardiovascular Medicine
• Oncology
• Pulmonary Vascular Disease

Background:

• A 52-year-old woman presented with chronic and worsening shortness of breath.
• Initial CT pulmonary angiogram suggested a large pulmonary embolism.

Observation:

• The chronic nature and imaging characteristics prompted referral to a specialist pulmonary vascular disease multidisciplinary team.
• PET-CT scan indicated a diagnosis more consistent with pulmonary artery sarcoma.

Findings:

• Pulmonary endarterectomy confirmed an extensive mass, later histologically identified as pulmonary artery angiosarcoma.
• Bilateral endarterectomy and pulmonary artery valve replacement were performed.
• The patient experienced a return to her baseline respiratory function post-surgery.

Implications:

• This case underscores the importance of considering rare diagnoses like pulmonary artery sarcoma in patients with suspected chronic thromboembolic disease.
• Multidisciplinary team evaluation and advanced imaging (PET-CT) are crucial for accurate diagnosis.
• Timely surgical intervention can lead to significant symptomatic improvement in patients with pulmonary artery angiosarcoma.