Paraneoplastic thrombus or relapse of a pulmonary artery sarcoma?
- University Hospital of Bern, Switzerland
- Correspondence to Dr Michel Oberson, University Hospital of Bern, Viale Cassone 32, Lugano-Pregassona 6963, Switzerland;
- Accepted 15 December 2009
- Published Online First 29 July 2010
A 34-year-old man with a previous history of left pneumectomy with curative intent after diagnosis of intimal sarcoma arising from the left pulmonary artery was referred for increasing dyspnoea, and pain at the right shoulder. The patient was free of tumour relapse at nearly 5 years follow-up.
A contrast-enhanced multidetector CT (MDCT) shows a filling defect within the main pulmonary artery (figure 1A). Axial fusion image of integrated [18F]fluorodeoxyglucose positron emission tomography (18FDG PET)/CT confirmed an increased uptake at the same level and additionally at the right scapula, highly suggestive of a metastasis (figure 1B). To relieve the patient's symptoms, and improve his quality of life and his short-term prognosis, a palliative operation was carried out. The main and the right pulmonary arteries were completely resected and successfully reconstructed using a polytetrafluoroethylene …