Epithelioid Angiosarcoma Presenting With Bilateral Hemothorax and Hemoptysis: A Case Report

We report a case of a 77-year-old man presenting with bilateral hemothorax, hemoptysis, and multiple bilateral pulmonary nodules and lung infiltrates. Histopathological and immunohistochemical analysis of a surgically resected nodule revealed epithelioid angiosarcoma, and the overall radiological and operative findings favored pulmonary origin. No other primary sites outside the thorax could be identified. The patient was planned for palliative chemotherapy, but his condition deteriorated, and he died before treatment could be initiated. Angiosarcoma is a rare and highly aggressive endothelial malignancy, most commonly affecting the skin and subcutaneous tissue of the head and neck. Primary pulmonary angiosarcoma is extremely uncommon; pulmonary involvement more often occurs through metastatic spread. When angiosarcoma involves the lungs as a primary neoplasm, it may present with multiple nodules, hemorrhagic lesions, or diffuse infiltrative patterns, frequently leading to hemoptysis and respiratory symptoms. Clinical course can be rapid, and prognosis is poor, particularly in advanced thoracic disease.