Key result
A single-stage surgical procedure involving right pneumonectomy under total circulatory arrest and embolectomy successfully managed a rare lung sarcoma with intracardiac extension, though the patient developed brain metastasis at 6 months.
Case Report (n=1)
A multidisciplinary single-stage surgical approach utilizing cardiopulmonary bypass and total circulatory arrest can successfully manage complex lung sarcomas with intracardiac extension and systemic embolization.
We present a challenging case of a high-grade spindle cell sarcoma originating in the right lung with intracardiac extension to the left atrium and left ventricle via the pulmonary veins, complicated by aorto-iliac thromboembolism. An 18-year-old male presented with sudden-onset bilateral lower limb weakness, low-grade fever, cough, and breathlessness. Computed tomography imaging revealed a large mediastinal mass with intracardiac extension and an infrarenal aortic thrombus. A multidisciplinary team performed a successful single-stage procedure involving excision of the intracardiac tumor via median sternotomy under cardiopulmonary bypass, right pneumonectomy under total circulatory arrest, and bilateral transfemoral embolectomy. Histopathology confirmed a high-grade spindle cell sarcoma with negative surgical margins. This case highlights the importance of a collaborative team approach, vigilant intraoperative monitoring, and the strategic use of circulatory arrest in managing complex thoracic tumors with intravascular extension.
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Penumaka et al. (2026) conducted a case report in High-grade spindle cell sarcoma of the lung with intracardiac extension and aorto-iliac thromboembolism (n=1). Single-stage surgical resection (intracardiac tumor excision, right pneumonectomy, bilateral transfemoral embolectomy) was evaluated. A single-stage surgical procedure involving right pneumonectomy under total circulatory arrest and embolectomy successfully managed a rare lung sarcoma with intracardiac extension, though the patient developed brain metastasis at 6 months.
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