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J Thorac Cardiovasc Surg 2009;137:e27-e29
© 2009 The American Association for Thoracic Surgery

Brief Communication

Low-grade sarcoma of the right upper lobe vein mimicking a metastatic disease

Dominique Fabre, MD*, Jeremie H. Lefevre, Vincent De Montpreville, Elie Fadel, Gaetano Rocco, Olivier Chataignier, Sacha Mussot, Philippe G. Dartevelle

Department of Thoracic and Vascular Surgery and Heart Lung Transplantation, Marie-Lannelongue Hospital–Paris Sud University, Paris, France

Received for publication March 16, 2008; revisions received April 15, 2008; accepted for publication May 5, 2008.

* Address for reprints: Dominique Fabre, MD, Department of Thoracic and Vascular Surgery and Heart Lung Transplantation, Marie-Lannelongue Hospital–Paris Sud University, 133 avenue de la résistance, 92350 Le Plessis Robinson, Paris, France. (Email: d.fabre@ccml.fr).

The first 20% of the full text of this article appears below.

We present a case of a 23-year-old patient with a primary tumor of the right upper vein and endocavitary expansion in the left atrium associated with concomitant infiltrative-like lesions of the upper and middle lobes. These lesions were suspected to be metastatic. The richly vascularized tumor was completely removed on cardiopulmonary bypass through a right thoracotomy. The pathologic findings showed a low-grade sarcoma invading the left atrium. The clinically suspected pulmonary metastases were in reality venous infarcts of the right upper and middle lobes. A complete obstruction of the pulmonary veins may create intrapulmonary lesions that can mimic metastatic lesions and should not exclude surgical treatment.

Clinical Summary

A 23-year-old man presented with recurrent hemoptysis after a pulmonary infection. The chest radiograph showed opacity of the right upper lobe. Chest computed tomography (CT) demonstrated a sizeable left atrial mass originating from the right upper vein (Figure 1 , A) and 2 lesions in the right upper and middle lobes (Figure 1, B). Tumor markers were negative. Transesophageal echography showed a 5 x 4–cm . . . [Full Text of this Article]






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