Atypical presentation and rapid deterioration in a patient with pulmonary artery sarcoma: a case report

Pulmonary artery sarcoma (PAS) is a rare disorder and can be challenging in terms of both diagnosis and treatment for cardiologists and cardiac surgeons. This case report describes a 63-year-old male who presented with acute dyspnea, exertional chest pain, and transient syncope, diagnosed with a massive saddle pulmonary embolism, without any significant risk factor. This impression was confirmed by echocardiography and computed tomography pulmonary angiography. Thrombolytic therapy was not effective, and the patient's conditions deteriorated. Therefore, the patient was scheduled for an embolectomy. Surprisingly, during the surgery, a large mass was detected at the bifurcation of the main pulmonary artery and mostly filling its lumen. This tumor was removed and diagnosed as PAS. Unfortunately, the patient's condition worsened over the next day, culminating in cardiopulmonary arrest and death. This case emphasizes the importance of considering differential diagnoses of pulmonary embolism in patients with atypical presentations and highlights the potential for rapid clinical decline despite aggressive management.