# Pulmonary artery sarcoma with mediastinal metastasis: a case report

## TL;DR

A 67-year-old man was diagnosed with a rare lung tumor that spread to his chest and caused artery issues, showing how a special CT scan helped in diagnosis.

## Contribution

This case report highlights the metastatic potential of pulmonary artery sarcoma to the mediastinum and its impact on pulmonary arteries.

## Key findings

- Pulmonary artery sarcoma can metastasize to the mediastinum and invade arteries, causing aneurysms.
- Dual-energy CT (DECT) was crucial in identifying and characterizing the tumor and its metastatic spread.
- Right lung cavitation improved with antifungal therapy, indicating a secondary infection.

## Abstract

We report a 67-year-old man presenting with a 9-month history of intermittent cough and chest pain. Dual-energy CT (DECT) demonstrated: (1) continuous filling defects extending from the main pulmonary artery through the right pulmonary artery into multiple segmental branches; (2) a middle mediastinal soft tissue mass closely related to the left pulmonary artery, left atrium, and left superior pulmonary vein, with spectral curve slope matching that of the intraluminal lesion in the pulmonary artery; (3) multiple irregular aneurysms in the left lower pulmonary artery; (4) cavitation in the right lung. Pulmonary artery biopsy confirmed undifferentiated pulmonary artery sarcoma. Pulmonary angiography revealed multiple left pulmonary artery aneurysms, and the right lung cavitation improved with antifungal therapy. This case demonstrates that pulmonary artery sarcoma can metastasize to the mediastinum, with metastatic lesions invading arteries and causing aneurysms. DECT plays a crucial role in diagnosis.