# Rare case report of main pulmonary artery occupying lesion: pulmonary artery intimal sarcoma

## TL;DR

A rare case of pulmonary artery intimal sarcoma is reported, highlighting the importance of imaging and surgery for diagnosis and treatment.

## Contribution

Presents a rare clinical case of PAIS with successful surgical management and no recurrence after two years.

## Key findings

- Multimodal imaging identified an irregular mass in the pulmonary artery, leading to surgical intervention.
- Histopathological confirmation of PAIS showed no recurrence or metastasis after two years without adjuvant chemotherapy.
- Early diagnosis and surgical resection are emphasized as critical for improved outcomes in PAIS.

## Abstract

Pulmonary artery intimal sarcoma (PAIS) is a rare aggressive malignant tumour that is easily confused with pulmonary embolism and poses considerable diagnostic challenges.

This case report details a 68-year-old male with progressive dyspnoea and chest tightness, initially misdiagnosed as pneumonia and pulmonary thromboembolism. Multimodal imaging, including echocardiography and contrast-enhanced computed tomography, identified an irregular mass within the pulmonary artery causing luminal stenosis, necessitating urgent surgical intervention. Histopathological examination confirmed PAIS. Postoperative recovery without adjuvant chemotherapy resulted in no recurrence or metastasis at a 2-year follow-up.

This case underscores the pivotal role of imaging in differentiating PAIS from thromboembolic conditions and highlights surgical resection as the cornerstone of treatment. Although the prognosis of PAIS remains poor, complete surgical excision may extend survival, emphasizing the importance of early multidisciplinary collaboration and long-term monitoring. This report advocates for increased clinical suspicion of PAIS in cases of refractory dyspnoea to reduce diagnostic delays.