Leiomyosarcoma of the pulmonary artery--a diagnostic chameleon.
A 60-year-old woman suffered from right-sided pain in the back and dyspnea suspicious for chronic pulmonary thromboembolism. Since computed tomography demonstrated a progressive filling defect within the left pulmonary artery, a transvenous biopsy was taken, which demonstrated malignant sarcoma. The patient underwent left-sided pneumonectomy with the aid of cardiopulmonary bypass. In case of a suspected 'chronic' pulmonary embolism with occlusion of a main pulmonary artery, as may be seen with imaging techniques, a sarcomatous disease should be ruled out, especially if there are no coagulation disorders, and the tumor obliterations progress in serial CT scans despite effective anticoagulation.
Hoffmeier
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Klinik und Poliklinik für Thorax-, Herz- und Gefässchirurgie, Universitätsklinik Münster, Albert Schweitzer Strasse 33, D-48149, Münster, Germany. andreas.hoffmeier@thgms.uni-muenster.de
Semik
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Fallenberg
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Scheld
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HH
D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000175:diagnosis*; D008875:Middle Aged; D011651:Pulmonary Artery; D011655:Pulmonary Embolism / Q000175:diagnosis; D019043:Vascular Neoplasms / Q000175:diagnosis*