Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2020; 8(5): 986-994
Published online Mar 6, 2020. doi: 10.12998/wjcc.v8.i5.986
Misdiagnosis of primary intimal sarcoma of the pulmonary artery as chronic pulmonary embolism: A case report
Ping Lu, Bei-Bei Yin
Ping Lu, Department of Cardiac Surgery, The First Affiliated Hospital of Shandong First Medical University, Jinan 250014, Shandong Province, China
Bei-Bei Yin, Department of Oncology, The First Affiliated Hospital of Shandong First Medical University, Jinan 250014, Shandong Province, China
Author contributions: Lu P and Yin BB analyzed the clinical data and images, reviewed the literature and wrote the manuscript; Yin BB conceived the idea and supervised the study; all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Bei-Bei Yin, MNAMS, Professor, Department of Oncology, The First Affiliated Hospital of Shandong First Medical University, No. 16766 Jingshi Road, Jinan 250014, Shandong Province, China. crystalred83@163.com
Received: December 10, 2019
Peer-review started: December 10, 2019
First decision: December 23, 2019
Revised: January 16, 2020
Accepted: January 24, 2020
Article in press: January 24, 2020
Published online: March 6, 2020
Abstract
BACKGROUND

Primary intimal sarcoma of the pulmonary artery is a rare malignant tumor originating from the pulmonary artery, which has a low incidence rate and is easily misdiagnosed as pulmonary embolism. There is no standard protocol for the treatment of primary intimal sarcoma of the pulmonary artery.

CASE SUMMARY

This study reports a patient with primary intimal sarcoma of the pulmonary artery who was admitted to our hospital in 2017. The clinical characteristics, diagnosis, treatment and outcome of the patient were retrospectively analyzed. The patient was a Chinese Han male aged 44 years. He had three consecutive episodes of syncope, and was thus admitted to a local hospital. Computed tomography pulmonary angiography showed multiple lesions with abnormal densities in the pulmonary trunk, left pulmonary artery, mediastinum and pericardium, which were consistent with recurrence after tumor resection. He underwent surgery, and was pathologically diagnosed with intimal sarcoma of the pulmonary artery. He relapsed 3 mo after surgery, and apatinib was administered. His condition was stable after 4 mo, with tolerable and controllable adverse reactions. He subsequently died 19 mo after surgery.

CONCLUSION

Primary intimal sarcoma of the pulmonary artery has no specific clinical or imaging manifestations. The diagnosis of this disease depends on histopathology and immunohistochemistry, and has a poor clinical prognosis. Surgical treatment is currently a favorable option for primary intimal sarcoma of the pulmonary artery, and targeted therapy may provide new insights for the development of effective treatment methods.

Keywords: Intimal sarcoma, Pulmonary artery, Pulmonary embolism, Misdiagnosis, Case report

Core tip: Primary intimal sarcoma of the pulmonary artery is a rare malignant tumor. Herein, we present the case of a 44-year-old man who showed multiple lesions with abnormal densities in the pulmonary trunk, left pulmonary artery, mediastinum and pericardium on computed tomography pulmonary angiography, which were consistent with disease recurrence. Three months after surgery, disease relapse was reported, and the patient was given apatinib. The patient’s condition was stable after 4 mo, with tolerable and controllable adverse reactions. The patient subsequently died 19 mo after surgery.