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原发性肺血管肉瘤偶然发现在一位复杂患者中:一例罕见病例报告。

Primary Pulmonary Angiosarcoma Found Incidentally in a Complicated Patient: A Rare Case Report.

机构信息

Lung Disease Research Center, Faculty of Medicine, Mashhad University of Medicine Sciences, Mashhad, Iran.

Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Clin Respir J. 2024 Aug;18(8):e13818. doi: 10.1111/crj.13818.

Abstract

INTRODUCTION

Primary pulmonary angiosarcoma (PPA) is a highly aggressive and rare malignancy originating from the endothelial cells of blood vessels in the lungs. PPA is an extremely rare subtype, with less than 30 cases reported to date. PPA is not only challenging to diagnose but also has a poor prognosis, often resulting in a high mortality rate within a year of diagnosis, regardless of the treatment approach.

METHOD

We present the case of a 33-year-old woman with no significant past medical history who presented with abdominal pain and was incidentally found to have a right hilar mass with pleural effusion and empyema. After undergoing surgery for a perforated gastric ulcer, her pulmonary lesions were further worked up. Despite an extensive diagnostic evaluation, including imaging, bronchoscopy, and thoracotomy, establishing a diagnosis was challenging. Ultimately, PPA was diagnosed on surgical lung biopsy, and the patient was started on pazopanib and paclitaxel chemotherapy but expired after 1 month due to multiple complications.

CONCLUSION

This case highlights the difficulty in diagnosing this rare tumor and its poor prognosis regardless of therapy. Greater awareness of PPA and more research are needed to improve early detection and treatment options for this deadly disease.

摘要

简介

原发性肺血管肉瘤(PPA)是一种源自肺部血管内皮细胞的高度侵袭性和罕见的恶性肿瘤。PPA 是一种极其罕见的亚型,迄今为止报告的病例不足 30 例。PPA 不仅难以诊断,而且预后不良,无论采用何种治疗方法,诊断后一年内死亡率通常很高。

方法

我们报告了一例 33 岁女性病例,无明显既往病史,因腹痛就诊,偶然发现右侧肺门肿块伴胸腔积液和脓胸。在因胃溃疡穿孔接受手术后,进一步检查了其肺部病变。尽管进行了广泛的诊断评估,包括影像学、支气管镜检查和剖胸术,但确定诊断仍具有挑战性。最终,通过手术肺活检诊断为 PPA,患者开始接受帕唑帕尼和紫杉醇化疗,但由于多种并发症,1 个月后死亡。

结论

本病例强调了诊断这种罕见肿瘤的困难及其无论治疗与否的不良预后。需要提高对 PPA 的认识并进行更多研究,以改善这种致命疾病的早期检测和治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/375d/11303451/b013211e52f4/CRJ-18-e13818-g002.jpg

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