Concealed Tracheal Angiosarcoma Beneath a Large Thyroid Mass-An Unexpected Cause of Intractable Hemoptysis

Angiosarcoma is a rare primary tracheal-bronchus origin tumor which was only reported in a few cases. The diagnosis and treatment for such a rare tumor has long been a challenge. In this case, a male hemoptysis patient who was initially misdiagnosed with thyroid carcinoma with tracheal invasion was finally diagnosed with tracheal angiosarcoma. A thick-walled cystic nodular mass was found preoperatively in the right thyroid lobe overlying the tracheal angiosarcoma, which contributed to our initial misdiagnosis. Flap bleeding and necrosis occured after the surgery and patient continued to cough blood even when we excised the whole flap, which suggested the intramural growth and local invasion of the angiosarcoma. This study also reviewed previous literactures on airway angiosarcoma and discussed the treatment strategy.