DOI QR코드

DOI QR Code

폐색전증으로 오인된 폐동맥내막육종 1예

A Case of Pulmonary Artery Intimal Sarcoma Masquerading as Pulmonary Embolism

  • 김진숙 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 박혜경 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 이혜란 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 강승대 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 배상철 (인제대학교 의과대학 일산백병원 내과학교실) ;
  • 김수영 (인제대학교 의과대학 일산백병원 영상의학교실) ;
  • 장선희 (인제대학교 의과대학 일산백병원 병리학교실) ;
  • 장우익 (인제대학교 의과대학 일산백병원 흉부외과학교실) ;
  • 강승희 (인제대학교 의과대학 일산백병원 치료방사선과학교실) ;
  • 이성순 (인제대학교 의과대학 일산백병원 내과학교실)
  • Kim, Jin-Suk (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Park, Hye-Kyeong (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Lee, Hye-Ran (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Kang, Seung-Dae (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Bae, Sang-Chul (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Kim, Su-Young (Department of Radiology, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Chang, Sun-Hee (Department of Pathology, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Chang, Woo-Ik (Department of Cardiosurgery, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Kang, Seung-Hee (Department of Radiation Oncology, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Lee, Sung-Soon (Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine)
  • 투고 : 2011.12.31
  • 심사 : 2012.02.06
  • 발행 : 2012.02.29

초록

Pulmonary artery intimal sarcoma is a rare tumor with no characteristic symptoms. It is frequently misdiagnosed as pulmonary embolism. We report a case of pulmonary artery intimal sarcoma in a 48-year-old man with dyspnea, cough and blood-tinged sputum. He was initially suspected and treated as a pulmonary embolism. Computed tomography of the chest showed filling defects occupying the entire luminal diameter of the right and left pulmonary artery as well as extraluminal extension of the intraluminal mass. Surgical resection of the tumor confirmed pulmonary artery intimal sarcoma. After surgery, he received 8 cycles of combined chemotherapy consisting of doxorubicin and ifosfamide. After 8 cycles, Computed tomography of the chest showed interval regression of the residual tumor. Radiotherapy was done as total 6,000 cGy for 5 weeks, following the 8th chemotherapy. The patient's condition was successfully stabilized with chemotherapy and radiotherapy.

키워드

참고문헌

  1. Delany SG, Doyle TC, Bunton RW, Hung NA, Joblin LU, Taylor DR. Pulmonary artery sarcoma mimicking pulmonary embolism. Chest 1993;103:1631-3. https://doi.org/10.1378/chest.103.5.1631
  2. Mattoo A, Fedullo PF, Kapelanski D, Ilowite JS. Pulmonary artery sarcoma: a case report of surgical cure and 5-year follow-up. Chest 2002;122:745-7. https://doi.org/10.1378/chest.122.2.745
  3. Head HD, Flam MS, John MJ, Lipnik SS, Slater DL,Stewart RD. Long-term palliation of pulmonary artery sarcoma by radical excision and adjuvant therapy. Ann Thorac Surg 1992;53:332-4. https://doi.org/10.1016/0003-4975(92)91345-A
  4. Hirose T, Ishikawa N, Hamada K, Inagaki T, Kusumoto S, Shirai T, et al. A case of intimal sarcoma of the pulmonary artery treated with chemoradiotherapy. Intern Med 2009;48:245-9. https://doi.org/10.2169/internalmedicine.48.1560
  5. Genoni M, Biraima AM, Bode B, Shan AC, Wilkler MB, Turina MI. Combined resection and adjuvant therapy improves prognosis of sarcomas of the pulmonary trunk. J Cardiovasc Surg (Torino) 2001;42:829-33.
  6. Blackmon SH, Rice DC, Correa AM, Mehran R, Putnam JB, Smythe WR, et al. Management of primary pulmonary artery sarcomas. Ann Thorac Surg 2009;87:977-84. https://doi.org/10.1016/j.athoracsur.2008.08.018
  7. Xu Y, Wang K, Geng Y, Shao Y, Yin Y. A case of intimal sarcoma of the pulmonary artery successfully treated with chemotherapy. Int J Clin Oncol 2011 Oct 27 [Epub]. DOI: 10 1007/s10147-011-0338-8.
  8. Mandelstamm M. Uber primare neubildungen des herzens. Virchows Archiv 1923;245:43-54. https://doi.org/10.1007/BF01992097
  9. Furest I, Marn M, Escribano P, Gomez MA, Cortinac J, Blanquer R. Intimal sarcoma of the pulmonary artery: a rare cause of pulmonary hypertension. Arch Bronconeumol 2006;42:148-50.
  10. Anderson MB, Kriett JM, Kapelanski DP, Tarazi R, Jamieson SW. Primary pulmonary artery sarcoma: a report of six cases. Ann Thorac Surg 1995;59:1487-90. https://doi.org/10.1016/0003-4975(95)00149-F
  11. Mayer E, Kriegsmann J, Gaumann A, Kauczor HU, Dahm M, Hake U, et al. Surgical treatment of pulmonary artery sarcoma. J Thorac Cardiovasc Surg 2001; 121:77-82. https://doi.org/10.1067/mtc.2001.111423
  12. Kruger I, Borowski A, Horst M, de Vivie ER, Theissen P, Gross-Fengels W. Symptoms, diagnosis, and therapy of primary sarcomas of the pulmonary artery. Thorac Cardiovasc Surg 1990;38:91-5. https://doi.org/10.1055/s-2007-1014001
  13. Yi CA, Lee KS, Choe YH, Han D, Kwon OJ, Kim S. Computed tomography in pulmonary artery sarcoma: distinguishing features from pulmonary embolic disease. J Comput Assist Tomogr 2004;28:34-9. https://doi.org/10.1097/00004728-200401000-00005
  14. Choi EY, Yoon YW, Kwon HM, Kim D, Park BE, Hong YS, et al. A case of pulmonary artery intimal sarcoma diagnosed with multislice CT scan with 3D reconstruction. Yonsei Med J 2004;45:547-51. https://doi.org/10.3349/ymj.2004.45.3.547
  15. Tueller C, Fischer Biner R, Minder S, Gugger M, Stoupis C, Krause TM, et al. FDG-PET in diagnostic work-up of pulmonary artery sarcomas. Eur Respir J 2010;35: 444-6. https://doi.org/10.1183/09031936.00114708