Key result
Palliative resection of pulmonary artery angiosarcoma misdiagnosed as PE provides only 2 months of survival.
Why the study?
Angiosarcomas of the heart and great vessels are frequently diagnosed late after metastasizing due to late onset and unspecific symptoms.
Case Report (n=1)
No
Tumor of the pulmonary artery should be considered as a rare differential diagnosis for pulmonary artery emboli.
BACKGROUND: Angiosarcomas are the most common malignant tumors of the heart and great vessels. Late onset and unspecific symptoms are reasons why a diagnosis is made rather late at a time when most tumors have already metastasized. We report a rare case of an angiosarcoma presenting as pulmonary artery emboli. CASE PRESENTATION: A 66-year-old patient was initially admitted to the hospital with a STEMI. Days later a successful reanimation due to ventricular fibrillation followed. An emboli of the pulmonary artery was diagnosed as the cause and after a lysis therapy the patient was discharged. A few weeks later the patient suffered an episode of absolute arrhythmia. TTE as well as CT-Scan showed an emboli of the pulmonary artery and a pericardial effusion with compression to the right ventricle. Intraoperative findings, showed an infiltrating tumor of the pulmonary artery, the pulmonary valve, the RVOT, the LA and LV. A resection of the tumor from the pulmonary artery, valve and RVOT was carried out. A new pulmonary valve was implanted with the reconstruction of the RVOT and pulmonary artery. Due to LV infiltration, only a palliative surgical approach was possible. Despite an uncomplicated postoperative course, the patient died at home two months later. CONCLUSION: Although a rarity, a tumor of the pulmonary artery should be taken into consideration as a differential diagnosis to pulmonary artery emboli. Development of better diagnostic tools (specific tumor markers) and more effective chemotherapeutic agents is necessary to improve the prognosis of these patients.
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Korça et al. (2022) conducted a case report in Angiosarcoma of the pulmonary artery (n=1). Surgical resection and pulmonary valve replacement was evaluated on Clinical outcome. A 66-year-old patient with a primary cardiac angiosarcoma of the pulmonary artery, initially misdiagnosed as pulmonary embolism, underwent palliative surgical resection but died two months later.
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