Shiue Cheng-Shiun, Chang Chao-Chun, Tsai Meng-Ta, Hu Yu-Ning
Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.
Division of Thoracic Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.
Diagnostics (Basel). 2025 Jul 5;15(13):1718. doi: 10.3390/diagnostics15131718.
We report a 26-year-old male presenting with a chronic cough and hemoptysis. Imaging revealed a large hypermetabolic mass in the left lower lung with the invasion of adjacent great vessels. A biopsy confirmed sarcomatoid carcinoma, a rare and aggressive form of primary pulmonary sarcoma. Due to vascular involvement, the patient underwent preoperative bronchial artery embolization followed by left pneumonectomy with pulmonary arterioplasty via median sternotomy. Postoperative recovery was uneventful. A two-year follow-up CT showed no recurrence. Primary pulmonary sarcomas are extremely rare, accounting for only 0.013-0.4% of lung malignancies, and are often diagnosed late due to nonspecific symptoms. This case highlights the importance of timely imaging, multidisciplinary planning, and aggressive surgical management in achieving long-term disease control, even in cases with extensive vascular invasion.
我们报告一例26岁男性，表现为慢性咳嗽和咯血。影像学检查显示左肺下叶有一个巨大的高代谢肿块，并侵犯了相邻的大血管。活检证实为肉瘤样癌，这是一种罕见且侵袭性强的原发性肺肉瘤。由于血管受累，患者接受了术前支气管动脉栓塞，随后通过正中胸骨切开术进行了左肺切除术及肺动脉成形术。术后恢复顺利。两年的随访CT显示无复发。原发性肺肉瘤极为罕见，仅占肺恶性肿瘤的0.013 - 0.4%，且由于症状不具特异性，常被误诊。该病例强调了及时进行影像学检查、多学科规划以及积极的手术治疗对于实现长期疾病控制的重要性，即使在存在广泛血管侵犯的病例中亦是如此。
