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Pulmonary Artery Intimal Sarcoma: A Diagnostic Challenge Using a Multimodal Approach
Nakrani, Rima Kim, Jin Sun Kamat, Bhishak Kumaran, Maruti
Nakrani, Rima
Kim, Jin Sun
Kamat, Bhishak
Kumaran, Maruti
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Journal article
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2020-10-05
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Medicine
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https://doi.org/10.1155/2020/6795272
Abstract
Pulmonary artery intimal sarcoma (PAIS) is a rare tumor without clear syndromic presentation other than nonspecific symptoms of cough, dyspnea, and weight loss. This diagnosis is difficult due to challenging radiographic interpretations of multiple imaging modalities. We present a case of a 60-year-old male, who presented to his pulmonologist and underwent a CT chest with IV contrast that initially suggested primary lung carcinoma. CT angiogram showed significant vascular filling defects suspicious of an intravascular mass, rather than vascular invasion by lung lesions. The PET/CT scans further suggested a malignant process, but indistinguishable between an extravascular or intravascular etiology. Taking these results together, they suggested an intravascular malignancy, prompting a tissue biopsy, which ultimately led to a diagnosis of PAIS with metastases. Establishing a definitive diagnosis is essential as treatment and prognosis are different for sarcoma compared to carcinoma. There is no standard treatment to date, and management often includes a multidisciplinary approach involving surgery, radiation, chemotherapy, and targeted therapy. PAIS is a rare entity that cannot be diagnosed clinically and needs a multimodality approach for its diagnosis.
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Rima Nakrani, Ho-Man Yeung, Jin Sun Kim, Bhishak Kamat, Maruti Kumaran, "Pulmonary Artery Intimal Sarcoma: A Diagnostic Challenge Using a Multimodal Approach", Case Reports in Medicine, vol. 2020, Article ID 6795272, 4 pages, 2020. https://doi.org/10.1155/2020/6795272
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Case Reports in Medicine, Vol. 2020, Article ID 6795272
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