title: Unresolved pulmonary embolism leading to a diagnosis of pulmonary artery sarcoma.
abstract: Pulmonary artery sarcomas (PAS) are rare tumors with a poor prognosis. They are often misdiagnosed as pulmonary embolism (PE) leading to futile anticoagulation treatment and delay in proper diagnosis. We present a case of a patient who was initially misdiagnosed and anticoagulated for presumed pulmonary embolism. Progressive symptoms and additional imaging led to the diagnosis of intimal pulmonary artery sarcoma for which he underwent surgical resection. This case serves as a reminder to consider pulmonary artery sarcoma in the differential diagnosis of patients with dyspnea and filling defects on CT pulmonary angiogram offering the potential for resection prior to metastasis.
authors.affiliation: Cleveland Clinic, Research Department of Molecular Cardiology, Cleveland, OH 44195, USA.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Gutiérrez
authors.affiliation: Department of Internal Medicine, Section of Pulmonary, Critical Care, & Sleep Medicine, Yale University, School of Medicine, New Haven, CT 06510, USA.
authors.forename: Maor
authors.initials: M
authors.lastname: Sauler
authors.affiliation: Department of Pathology and Cell Biology, Columbia University Medical Center, USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Mitchell
authors.affiliation: Department of Internal Medicine, Section of Pulmonary, Critical Care, & Sleep Medicine, Yale University, School of Medicine, New Haven, CT 06510, USA.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Siegel
authors.affiliation: Department of Internal Medicine, Section of Pulmonary, Critical Care, & Sleep Medicine, Yale University, School of Medicine, New Haven, CT 06510, USA.
authors.forename: Terence K
authors.initials: TK
authors.lastname: Trow
authors.affiliation: Department of Surgery, Section of Thoracic Surgery, Columbia University Medical Center, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Bacchetta
authors.affiliation: Department of Internal Medicine, Section of Pulmonary, Critical Care, & Sleep Medicine, Yale University, School of Medicine, New Haven, CT 06510, USA. Electronic address: wassim.fares@yale.edu.
authors.forename: Wassim H
authors.initials: WH
authors.lastname: Fares
mesh_terms: D000792:Angiography; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004417:Dyspnea / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000473:pathology*; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology*; D012509:Sarcoma / Q000175:diagnosis* / Q000473:pathology; D019043:Vascular Neoplasms / Q000175:diagnosis* / Q000473:pathology
keywords: Diagnosis; Differential; Neoplasm; Pulmonary embolism; Pulmonary hypertension; Radiography; Sarcoma