Chondrosarcoma presenting as dyspnea in a 19-year-old man: a case report

Rajasekharan Chandrasekharan,Mithun Chalakarayil Bhagavaldas,Ashish Jacob Mathew

doi:10.1186/1752-1947-5-150

Rajasekharan Chandrasekharan, Mithun Chalakarayil Bhagavaldas + Show 1 more

Open Access

https://doi.org/10.1186/1752-1947-5-150

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Abstract

IntroductionAcute pulmonary embolism has varied presentations ranging from asymptomatic, incidentally discovered emboli to massive embolism, causing immediate death. Tumor embolism is a rare but unique complication of malignancies. This uncommon catastrophe of a malignant tumor in a young patient, culminating as a pulmonary embolism, is being reported for the first time.Case presentationA 19-year-old Asian man presented to the emergency service at our hospital with acute onset dyspnea. His clinical examination led to the suspicion of an acute pulmonary embolism with a lower lumbosacral radiculopathy. A magnetic resonance imaging scan of the pelvis demonstrated a chondrosarcoma arising from the right iliac wing, eroding into the common iliac vein and creeping up the inferior vena cava to lodge in the pulmonary artery, thus producing a saddle embolus.ConclusionThe importance of exploring for malignancies in the event of an idiopathic pulmonary embolism is highlighted. Early detection of such malignancies can substantially affect the outcome in young patients.

Highlights

Acute pulmonary embolism has varied presentations ranging from asymptomatic, incidentally discovered emboli to massive embolism, causing immediate death
The importance of exploring for malignancies in the event of an idiopathic pulmonary embolism is highlighted. Detection of such malignancies can substantially affect the outcome in young patients
We report an unusual presentation of a tumour embolism in a young man, who succumbed to the disease

Summary

Introduction

Detached thrombi or tumour may be the cause for massive pulmonary embolism in patients with malignancies. Case report A 19-year-old Asian man, was admitted to the emergency services (ES) at our hospital with acute onset of severe breathlessness following a short duration of dry cough, without any associated fever, chest pain or hemoptysis. He had lower-back pain and right lower limb weakness with paresthesia, which was attributed to an injury sustained while playing football. An acid base analysis showed compensated respiratory acidosis His chest radiograph revealed a wedge-shaped opacity in the right midzone with dilated main pulmonary artery and focal oligemia in the right lower zone, which may have been suggestive of a pulmonary embolism.

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