Longitudinal observation of solitary fibrous tumor translation into malignant pulmonary artery intimal sarcoma
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(2020) 15:233
CASE REPORT
Open Access
Longitudinal observation of solitary fibrous tumor translation into malignant pulmonary artery intimal sarcoma Rui Luo1, Yingshuo Jiang2, Yue Huang3, Xin Chen2 and Feng Wang1*
Abstract Background: Pulmonary artery intimal sarcoma (PAIS) is a rare malignant tumor that was usually misdiagnosed as chronic pulmonary thromboembolism. Case presentation: We previously reported a solitary fibrous tumor in the pulmonary artery presented with acute pulmonary embolism, which was identified by 99mTc-Galacto-RGD2 imaging. However, this patient had a recurrence in situ two-year after surgery, post-operative pathology revealed pulmonary artery intimal sarcoma. At one-year post-operation, 18F-FDG PET/CT was performed for exclusion of tumor metastasis, which showed FDG avid lesion in the T5, T10, and L5 vertebral bodies, as well as in bilateral ilium and right ischium. Conclusions: This is the first longitudinal observation of a solitary fibrous tumor (SFT) development into a pulmonary artery intimal sarcoma (PAIS) and presented with multiple bone metastases. Keywords: Pulmonary artery intimal sarcoma, Solitary fibrous tumor, Malignant potential, emission tomography
Background Pulmonary artery intimal sarcoma (PAIS) is a rare malignant tumor that may be misdiagnosed as chronic pulmonary thromboembolism [1, 2]. We previously reported a solitary fibrous tumor in the pulmonary artery presented with acute pulmonary embolism, which was identified by 99mTc-Galacto-RGD2 imaging [3]. However, this patient had a recurrence in situ two-year after surgery, post-operative pathology revealed pulmonary artery intimal sarcoma. This is the first longitudinal observation of a solitary fibrous tumor (SFT) development into a pulmonary artery intimal sarcoma (PAIS) and presented with multiple bone metastases.
* Correspondence: [email protected]; [email protected] 1 Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, 68th Changle Road, Nanjing 210006, China Full list of author information is available at the end of the article
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F-FDG, Positron
Case presentation The 70-year-old female patient we previously reported with pulmonary solitary fibrous tumors (SFT), presented with increasingly aggravated oppression in chest but released after rest. Transthoracic echocardiography revealed a 43.7 mm × 15.9 mm solid echo-level mass which attached to the lower part of the main pulmonary artery and the beginning of left pulmonary artery, no significant blood stream was seen in the left pulmonary artery, whereas partial blood stream passed the right pulmonary artery. Ultrasonic spectroscopy found the velocity of blood flow of tricuspid valve was 4.3 m/s, which was turbulent flow (Fig. 1). Chest CT showed partial higher density shadow of pulmonary trunk and left branch (Fig. 2). Herein, after cardiopulmonary bypass was established, the aorta was opened and the mass was carefully resected. The surface of the mass was smooth, white and elastic and attached to the main pulmonary
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