Primary Pulmonary Angiosarcoma: Case Report and Literature Review

Pulmonary angiosarcoma is a rare and aggressive tumour arising from the endothelial cells of the pulmonary vasculature. The average survival from time of diagnosis is 9 months. This cancer presents challenges due to small nodules, pleural effusion, and hemoptysis often being confused for benign diagnosis. We present a case of primary pulmonary angiosarcoma with similar diagnostic challenges and a rapidly declining functional status. Our patient had a non-diagnostic CT-guided lung biopsy and iliac crest bone biopsy. Definitive diagnosis was achieved by robotic navigational bronchoscopy of a 2.5 cm left lingula nodule, which identified tumour cells positive for CD31, consistent with epithelioid angiosarcoma. Despite transient improvement with supportive care, the patient's condition deteriorated, culminating in cardiac arrest and death. Our study reviews clinical courses, diagnostic tools, and treatment available for pulmonary angiosarcoma and highlights the importance of robotic biopsy as an earlier diagnostic tool for such aggressive pulmonary cancers.