Case report: angiosarcoma of the pulmonary artery diagnosed as 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 arte...

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Published in:Journal of cardiothoracic surgery 2022-11, Vol.17 (1), p.1-288, Article 288
Main Authors: Korça, Edina, Kanaan, Jad, Benke, Kálmán, Veres, Gábor, Michaelsen, Jens, Szabó, Gábor
Format: Article
Language:English
Subjects:
Angiosarcoma
Arrhythmia
Autopsies
Blood clots
Blood vessels
Cancer
Cardiac tumor
Cardiology
Care and treatment
Case Report
Case reports
Catecholamines
Chemotherapy
Compression
Computed tomography
Diagnosis
Differential diagnosis
Dyspnea
Effusion
Ejection fraction
Emboli
Heart
Heart attacks
Intensive care
Lysis
Magnetic resonance imaging
Metastases
Metastasis
Patients
Pulmonary arteries
Pulmonary artery
Pulmonary embolisms
Surgery
Sutures
Tomography
Transplants & implants
Tumor markers
Tumors
Veins & arteries
Ventricle
Ventricular fibrillation
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Summary: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. Keywords: Angiosarcoma, Emboli, Pulmonary artery, Cardiac tumor
ISSN:1749-8090
1749-8090
DOI:10.1186/s13019-022-02036-w