Pulmonary Artery Intimal Sarcoma Mimicking Pulmonary Embolism: A Case Report

TL;DR

A rare case of pulmonary artery intimal sarcoma was misdiagnosed as pulmonary embolism, highlighting the need for careful differentiation using imaging features.

Contribution

The case emphasizes the importance of considering intimal sarcoma in patients with persistent pulmonary embolism-like symptoms unresponsive to standard treatment.

Findings

Persistent intraluminal filling defects and inadequate response to anticoagulation led to the diagnosis of intimal sarcoma.

Imaging features like SUVmax and wall eclipsing sign can help differentiate intimal sarcoma from pulmonary embolism.

Abstract

Pulmonary artery intimal sarcoma is a very rare and often misdiagnosed cause of pulmonary artery occlusion and progressive dyspnoea. A case of a 66-year-old man is presented, initially treated for presumed pulmonary embolism, in whom persistent intraluminal filling defects and inadequate therapeutic response ultimately led to the diagnosis of intimal sarcoma.

Teaching point: Pulmonary artery intimal sarcoma should be considered in cases of persistent suspected pulmonary embolism unresponsive to adequate anticoagulation or thrombolysis, with imaging features such as SUVmax, metabolic tumour volume, total lesion glycolysis, and the wall eclipsing sign helping in the differentiation between the two entities.

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