Abstract
Intimal sarcoma of the pulmonary artery is a rare malignant tumor that may be misdiagnosed as chronic pulmonary thromboembolism, even if various imaging techniques are used. We report a case of a 58-year-old man with pulmonary artery intimal sarcoma.18F-fleuorodeoxyglucose (FDG) uptake was poor in the mass of the pulmonary artery, and no other hypermetabolic lesions were noted elsewhere. Our presumptive diagnosis was a massive mural thrombus and a concomitant chronic thromboembolism. Intravenous heparin and recombinant human tissue-type plasminogen activator was subsequently administered. However, the patient needed an emergency operation for sudden aggravation of the vital signs, and the tissue diagnosis was intimal sarcoma with poor clinical outcomes.
Highlights
Intimal sarcoma is a rare mesenchymal tumor, and it can arise from the great arteries
The usual features of these tumors are endoluminal growth and later vessel obstruction or seeding of distal emboli. In rare cases, it may extend in a retrograde fashion to the pulmonary valve and the right ventricle [1,2]
Several authors have reported that FDG-PET has been useful in a diagnostic workup for differentiating among or staging malignant diseases, and monitoring the response to treatment of pulmonary artery intimal sarcoma [4,5]
Summary
Intimal sarcoma is a rare mesenchymal tumor, and it can arise from the great arteries. The incidence of pulmonary artery intimal sarcoma is almost twice that of the aorta [1]. It usually arises from the intimal layer of the right, left, and main pulmonary arteries.
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