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J Thorac Cardiovasc Surg 2002;123:581
© 2002 The American Association for Thoracic Surgery

Letters to the Editor

Pulmonary artery sarcoma

Department of Cardiothoracic Surgery
St Luke's Hospital
G'Mangia, Malta

To the Editor:

In the January 2001 issue of the Journal, Mayer and associates ¹ discussed the surgical treatment of pulmonary artery sarcoma. The diagnosis of such a rare condition can be difficult and is usually made from histologic findings after surgery or at postmortem examination. In most patients this condition is erroneously diagnosed as pulmonary thromboembolism or bronchogenic carcinoma.

A 73-year-old woman was referred to us with a 3-month history of hemoptysis, weight loss, fatigue, and dyspnea. She was anemic and received a transfusion of 6 units of blood. A chest x-ray film showed consolidation of the middle lobe of the right lung. A computed tomographic scan demonstrated a 5-cm mass medially in the right middle lobe that was believed to be bronchogenic carcinoma. There was no evidence of lymph node enlargement. Bronchoscopic examination showed no lesions in the bronchial mucosa but defined the site of the hemoptysis. At thoracotomy, a mobile right middle lobe engorged with dark clotted blood and containing a solid central mass was found. A right middle lobectomy was performed. Histopathologic examination showed a low-grade pulmonary artery sarcoma. Postoperatively, the woman made an uneventful recovery. Six weeks postoperatively she was given radiotherapy to the right hilum. She is alive and well 6 months after the operation.

The sarcoma in this woman arose from a secondary pulmonary artery, in contrast to many of the sarcomas described in the literature, which were shown to arise from the main right or left pulmonary artery. ² This made resection of the tumor in our patient easier without the need for cardiopulmonary bypass and pulmonary artery reconstruction. Although our patient had postoperative radiotherapy, the role of adjuvant therapy in patients with such tumors is not yet defined.

12/8/121501doi:10.1067/mtc.2002.121501

References

1. Mayer E, Kriegsmann J, Gaumann A, Kauczor HU, Dahm M, Hake U, et al. Surgical treatment of pulmonary artery sarcoma. J Thorac Cardiovasc Surg. 2001;121:77-82.
   
2. Burke AP, Virmani R. Sarcomas of the great vessels: a clinicopathological study. Cancer. 1993;71:1761-73.[Medline]
   

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Joseph Galea Alexander Manché Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Galea, J. Articles by Manché, A. Search for Related Content PubMed PubMed Citation Articles by Galea, J. Articles by Manché, A. Related Collections Lung - cancer