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Pulmonary Artery Intimal Sarcoma Mimicking Intraluminal Seeding: A Case Report
Akira Akazawa1,2, Jun Hanaoka2, Takuya Shiratori2
1Department of General Thoracic Surgery, National Hospital Organization Higashi-Ohmi General Medical Center, Higashi-Ohmi, Shiga, Japan.
Introduction:
Pulmonary artery intimal sarcoma (PAIS) is a rare vascular malignancy. Complete surgical resection is crucial for favorable outcomes; however, intraoperative delineation of the tumor extent poses a significant challenge.
Case Presentation:
A 63-year-old woman with suspected PAIS underwent a left pneumonectomy under cardiopulmonary bypass. Despite macroscopically clear margins, histopathological examination of the pulmonary artery (PA) stump exhibited tumor infiltration, necessitating reevaluation. We identified multiple skip-like intraluminal nodules along the PA and performed resection and subsequent reconstruction utilizing an autologous pericardial patch. The final pathology demonstrated not only nodular lesions but also creeping intimal infiltration in segments without gross abnormalities.
Conclusions:
Although PAIS typically exhibits contiguous spread along the intima, the presence of skip-like nodules and subtle creeping infiltration is rare, complicating intraoperative assessment. Comprehensive intraoperative and pathological assessments are essential to achieve a complete resection.
