Stenting for pulmonary artery stenosis due to a recurrent primary leiomyosarcoma.
OBJECTIVE
To report stent implantation for a malignant obstruction within the pulmonary artery (PA) caused by a recurrent leiomyosarcoma in the pulmonary trunk.


METHODS
A 62-year-old man with a non-metastatic primary leiomyosarcoma of the right PA underwent pneumectomy of the right lung and postoperative radiotherapy in 1994. Six years later, he presented with symptoms of progressive right ventricular dysfunction. Computed tomography (CT) identified a high-grade stenosis of the left PA due to recurrent tumor within the pulmonary trunk extending into the left PA. Transthoracic ultrasound documented severe pulmonary hypertension with a high pressure gradient across the stenosis. A stent was deployed percutaneously, successfully establishing PA patency. Pressure measurements showed a significantly reduced gradient across the stented area. In follow-up, the patient reported subjective improvement of symptoms; CT scans revealed a fully patent stent. His status remained stable 11 months after stent implantation.


CONCLUSIONS
PA leiomyosarcoma is a rare and highly malignant tumor. In most cases, surgery can only prolong survival for the short term. Palliative interventional PA stenting performed under local anesthesia can offer improvement in quality of life by reducing excessive pulmonary hypertension.
Meckel
Stephan
S
Division of Interventional Radiology, Department of Diagnostic Radiology, University Hospital Basel, Switzerland.
Buitrago-Téllez
Carlos
C
Herrmann
Richard
R
Jacob
Augustinus Ludwig
AL
D003251:Constriction, Pathologic; D006801:Humans; D007890:Leiomyosarcoma / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011651:Pulmonary Artery / Q000473:pathology* / Q000601:surgery*; D015607:Stents; D019043:Vascular Neoplasms / Q000150:complications*; D014654:Vascular Patency