Taichiro Goto1, Arafumi Maeshima, Ryoichi Kato. 1. Department of General Thoracic Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan. taichiro@1997.jukuin.keio.ac.jp
Abstract
BACKGROUND: Cases of pulmonary artery masses have only rarely been reported, and the optimal type of the diagnosis and treatment is controversial. CASE PRESENTATION: An 81-year-old woman was found to have an abnormal shadow on chest X-ray film. Computed tomography showed an irregularly bordered tumor centered in the hilar region extending from segment 6 to the middle lobe of the right lung. Pulmonary angiography showed complete occlusion of the trunk at the periphery proximal to the bifurcation of the posterior ascending branch. Based on bronchoscopic biopsy of the tumor, an adenocarcinoma was diagnosed. Middle and lower lobectomy was performed. Histopathologically, the adenocarcinoma had invaded the tunica intima of the pulmonary artery and also replaced the endothelium in the same region. Although a large thrombus was found at the vessel invasion site of the adenocarcinoma in the pulmonary artery, there were no malignant findings in the thrombus itself. CONCLUSIONS: This is the first reported case of radical resection of a lung cancer with invasion along the pulmonary artery wherein a benign thrombus had formed. In general, surgery would be the treatment of choice for a pulmonary artery mass.
BACKGROUND: Cases of pulmonary artery masses have only rarely been reported, and the optimal type of the diagnosis and treatment is controversial. CASE PRESENTATION: An 81-year-old woman was found to have an abnormal shadow on chest X-ray film. Computed tomography showed an irregularly bordered tumor centered in the hilar region extending from segment 6 to the middle lobe of the right lung. Pulmonary angiography showed complete occlusion of the trunk at the periphery proximal to the bifurcation of the posterior ascending branch. Based on bronchoscopic biopsy of the tumor, an adenocarcinoma was diagnosed. Middle and lower lobectomy was performed. Histopathologically, the adenocarcinoma had invaded the tunica intima of the pulmonary artery and also replaced the endothelium in the same region. Although a large thrombus was found at the vessel invasion site of the adenocarcinoma in the pulmonary artery, there were no malignant findings in the thrombus itself. CONCLUSIONS: This is the first reported case of radical resection of a lung cancer with invasion along the pulmonary artery wherein a benign thrombus had formed. In general, surgery would be the treatment of choice for a pulmonary artery mass.
Authors: Andrew O Zurick; Veronica Lenge De Rosen; Carmela D Tan; E Rene Rodriguez; Scott D Flamm; Paul Schoenhagen Journal: Circulation Date: 2011-09-06 Impact factor: 29.690
Authors: Nihan Kayalar; Bradley C Leibovich; Thomas A Orszulak; Hartzell V Schaff; Thoralf M Sundt; Richard C Daly; Christopher G A McGregor Journal: J Thorac Cardiovasc Surg Date: 2009-06-10 Impact factor: 5.209