Hemangioendotelioma epitelióide do pulmão – Raridade, dificuldades diagnósticas e terapêutica

Abstract

The authors report a case of a primary pulmonary epithelioid haemangioendothelioma (EHE) in a 51 year-old man, a mechanic, who complained of a dry cough followed by constitutional symptoms and dyspnoea. Patient underwent a series of diagnostic exams including surgical biopsy and pulmonary tuberculosis was diagnosed. He was prescribed tuberculosis drugs for three weeks. Following clinical and imagiology deterioration, the case was reviewed by pathologists who concluded the pulmonary biopsy revealed an intermediate/high grade pulmonary EHE/angiosarcoma. The patient underwent three cycles of chemotherapy with carboplatin, etoposide and bevacizumab with no complications. He died seven months after onset of symptoms and seven weeks after definitive diagnosis.The authors wish to highlight the rarity of this pulmonary neoplasm and the importance of clinical suspicion, and the diagnosis and treatment difficulties in addition to the potential benefits of antiangiogenic drugs.Rev Port Pneumol 2009; XV (6): 1167-1174