Pulmonary artery obstruction due to a metastatic malignant phyllodes tumor of the breast.
A 65-year-old woman with a 9-year surgical history of a left breast phyllodes tumor was admitted with progressive chest pain on effort. Computed tomography showed severe stenosis of the main pulmonary artery, with the mass originating from the ventricular septum. We planned to resect the tumor the next day. However, the next morning a pulmonary artery embolism occurred, and she developed dyspnea and lost consciousness. After carrying out cardiopulmonary resuscitation, we performed a life-saving operation. We successfully resected the huge tumor as far as possible from the right ventricle via a right atrial (RA)-tomy. However, her consciousness did not improve to better than Glasgow Coma Scale grade 7. She died from suffocation caused by metastasis invading her airway despite undergoing tracheotomy on the 77 th postoperative day.
Nakatsu
Taro
T
Department of Cardiovascular Surgery, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, Kumamoto, 862-0925, Japan. tarozamurai@hotmail.com
Koshiji
Takaaki
T
Sakakibara
Yutaka
Y
Hagio
Koji
K
Ishigami
Masanosuke
M
Arima
Yuichiro
Y
Kitaoka
Mitsuhiko
M
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D001237:Asphyxia / Q000209:etiology; D001943:Breast Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D006348:Cardiac Surgical Procedures; D003251:Constriction, Pathologic; D017809:Fatal Outcome; D005260:Female; D006338:Heart Neoplasms / Q000150:complications* / Q000556:secondary / Q000601:surgery; D006801:Humans; D003557:Phyllodes Tumor / Q000150:complications* / Q000556:secondary / Q000601:surgery; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000209:etiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014474:Unconsciousness / Q000209:etiology; D054088:Ventricular Septum / Q000473:pathology