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1.
Surg Pathol Clin ; 14(4): 645-663, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34742485

RESUMO

Vascular tumors of bone can be diagnostically challenging because of their rarity and histologic overlap with diverse mimics. Vascular tumors of bone can be categorized as benign (hemangioma), intermediate-locally aggressive (epithelioid hemangioma), intermediate-rarely metastasizing (pseudomyogenic hemangioendothelioma), and malignant (epithelioid hemangioendothelioma and angiosarcoma). Recurrent genetic alterations have been described, such as FOSB rearrangements in pseudomyogenic hemangioendothelioma and a subset of epithelioid hemangiomas; CAMTA1 or TFE3 rearrangements in epithelioid hemangioendothelioma. This review discusses the clinical, histologic, and molecular features of vascular tumors of bone, along with diagnostic pitfalls and strategies for avoidance.


Assuntos
Hemangioendotelioma Epitelioide , Hemangiossarcoma , Neoplasias de Tecido Vascular , Sarcoma , Neoplasias Vasculares , Adulto , Criança , Hemangioendotelioma Epitelioide/diagnóstico , Hemangioendotelioma Epitelioide/genética , Humanos , Neoplasias Vasculares/diagnóstico
2.
Ann Card Anaesth ; 24(4): 483-486, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34747760

RESUMO

Uterine leiomyoma (UL) is the most common benign smooth muscle tumour of the premenopausal women. Rarely it shows malignant behaviour by metastasizing through the pelvic veins into systemic veins, inferior vena cava (IVC), there it is termed as intravenous leiomyomatosis (IVL). IVL may restrict itself within the IVC or it may extend into right heart chambers reaching up to pulmonary arteries. Here we report a case of single staged excision of intracardiac(IC) extension of IVL of a 45 -year -old premenopausal women, who have undergone abdominal hysterectomy five years ago, with the complaints of shortness of breath aggravated on bending forward for the past two years.


Assuntos
Neoplasias Cardíacas , Leiomiomatose , Neoplasias Pélvicas , Neoplasias Uterinas , Neoplasias Vasculares , Feminino , Átrios do Coração , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Humanos , Histerectomia , Leiomiomatose/diagnóstico por imagem , Leiomiomatose/cirurgia , Neoplasias Pélvicas/diagnóstico por imagem , Neoplasias Pélvicas/cirurgia , Neoplasias Uterinas/cirurgia , Neoplasias Vasculares/diagnóstico por imagem , Neoplasias Vasculares/cirurgia , Veia Cava Inferior/diagnóstico por imagem , Veia Cava Inferior/cirurgia
3.
BMJ Case Rep ; 14(11)2021 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-34753722

RESUMO

Primary pulmonary angiosarcoma is a rare type of malignant vascular tumour with poor prognosis. Diagnosis is often late due to non-specific symptoms and low clinical suspicion for angiosarcoma. A 72-year-old man presented to hospital with a 6-month history of mild progressive dyspnoea, with associated cough, episodes of presyncope and weight loss. CT pulmonary angiogram (CTPA) was reported as a large saddle pulmonary embolism extending into both the right and left pulmonary arteries. Further Multidisciplinary team meeting (MDM) discussion, and review of CTPA and subsequent investigations revealed a large primary pulmonary artery sarcoma which was later confirmed histology. The patient was referred to the cardiothoracic surgeons and underwent left radical pneumonectomy.


Assuntos
Hemangiossarcoma , Embolia Pulmonar , Neoplasias Vasculares , Idoso , Hemangiossarcoma/diagnóstico por imagem , Hemangiossarcoma/cirurgia , Humanos , Pulmão , Masculino , Pneumonectomia , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/cirurgia , Neoplasias Vasculares/diagnóstico por imagem , Neoplasias Vasculares/cirurgia
4.
Cir Cir ; 89(S1): 6-9, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34762620

RESUMO

Epitheloid hemangioendothelioma is a very rare tumor, with a variable presentation and unpredictable clinical behavior. The etiology and the triggering risk factors have not been specified. Unlike other primary liver tumors, it does not arise in the background of chronic liver disease. The approach is challenging due to the spectrum of possibilities and the need for immunohistochemistry to establish the definitive diagnosis. The information available so far is limited due to the few published cases, this favors that the therapeutic options are few or that there is insufficient evidence to standardize them when the lesion is not resectable.


Assuntos
Hemangioendotelioma Epitelioide , Neoplasias Hepáticas , Neoplasias Vasculares , Hemangioendotelioma Epitelioide/diagnóstico , Hemangioendotelioma Epitelioide/cirurgia , Humanos , Imuno-Histoquímica , Neoplasias Hepáticas/diagnóstico
5.
Zhonghua Bing Li Xue Za Zhi ; 50(9): 1029-1033, 2021 Sep 08.
Artigo em Chinês | MEDLINE | ID: mdl-34496494

RESUMO

Objective: To investigate the clinicopathological features of hepatic vascular tumors in children. Methods The clinical characteristics, histology and immunohistochemical staining results were summarized and analyzed in 22 cases of hepatic vascular tumors in children at Guangzhou Women and Children's Medical Center from September 2007 to November 2020. Results: The 22 patients aged from 1.0 month to 2.5 years (mean age 9 months). There were 10 males and 12 females. Five cases were found in premature and had low birth weight infants; three cases were discovered in the antenatal period; one patient also had cutanous hemangioma; six patients had associated anemia; Kasabach-Merritt phenomenon was not seen in any patient. CT examination showed 17 tumors were solitary and five were multifocal lesions. Macroscopically, the tumors size ranged from was 0.6 cm to 11.0 cm; the cut surface was solid, gray red and brown in color, and in six cases there were hemorrhage and necrosis in the central area. Microscopically,15 cases of solitary congenital hepatic hemangiomas showed characteristic necrosis in the central area, with loose fibrous tissues at periphery. Proliferation of capillaries, residual bile ducts between the vascular lumens, and dilated thrombosed vascular channels were seen, and contained extramedullary hematopoietic foci and calcification. Five cases of multiple hepatic infantile hemangiomas showed capillaries of different sizes composing of plump endothelium and pericytes and were arranged in lobular or diffuse patterns. Two cases of cavernous hemangioma (venous malformation) consisted of dilated thin-walled blood vessels with branch-like pattern lined with flat endothelial cells. Immunohistochemically, all 22 case expressed vascular endothelial markers CD31 and CD34, but D2-40 was negative. Glut1 was positive in five cases of multiple hepatic infantile hemangiomas, and the other cases were negative. Conclusion: Hepatic vascular tumors in children are rare, and their classification is different from that of adults. It is of great significance to make clear pathologic diagnosis.


Assuntos
Hemangioma , Síndrome de Kasabach-Merritt , Neoplasias Vasculares , Criança , Células Endoteliais , Feminino , Humanos , Lactente , Fígado , Masculino , Gravidez
6.
Eur J Med Res ; 26(1): 89, 2021 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-34372932

RESUMO

BACKGROUND: Pulmonary artery intimal sarcoma (PAS) is a very rare disease, its prevalence is about 0.001-0.003%. PAS is often misdiagnosed as acute or chronic pulmonary thromboembolism due to its clinical presentation and radiological findings. Thus, early diagnosis is very crucial and may improve patient outcome. CASE PRESENTATION: Here, we report a case in a Chinese male where the symptom presentation was episodes of shortness of breath. Transthoracic echocardiography showed a solid mass in the pulmonary valve orifice, which was demonstrated to be a pulmonary artery intimal sarcoma diagnosed by histopathology. In this case, the initial differential diagnosis included pulmonary embolism. Because the initial symptom of primary pulmonary artery sarcoma is extremely similar to the pulmonary embolism, half of them may be misdiagnosed as pulmonary embolism. Imaging studies are very helpful. Ultrasound and CT are the best due to their resolution and ability to assess the relationship of the mass with the surrounding structures. The final diagnosis is mostly made after surgical excision and this is the most effective treatment. At the same time, radiotherapy and chemotherapy after surgery is also an adjuvant treatment. CONCLUSION: We report a very rare case of pulmonary artery intimal sarcoma. Due to late diagnosis and delayed treatment in this case, the patient displayed a poor prognostic. Early diagnosis and right treatment can improve the prognosis of PAS and optimize overall health.


Assuntos
Hemangiossarcoma/diagnóstico , Artéria Pulmonar/patologia , Túnica Íntima/patologia , Neoplasias Vasculares/diagnóstico , Idoso , Diagnóstico Diferencial , Hemangiossarcoma/diagnóstico por imagem , Humanos , Masculino , Artéria Pulmonar/diagnóstico por imagem , Embolia Pulmonar/diagnóstico , Tomografia Computadorizada por Raios X , Túnica Íntima/diagnóstico por imagem , Ultrassonografia , Neoplasias Vasculares/diagnóstico por imagem
7.
Sci Rep ; 11(1): 16062, 2021 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-34373472

RESUMO

To evaluate the clinicopathological characteristics and prognosis of gastrointestinal vascular tumours. By reviewing the information from the electronic medical record system and pathology database of Hangzhou First People's Hospital affiliated with Zhejiang University School of Medicine and Jiaxing First People's Hospital from June 2008 to December 2019, 31 patients pathologically diagnosed with vascular tumours were included in this study. The age of onset, sex differences, clinical manifestations, imaging and endoscopic characteristic manifestations, pathological characteristics, treatment methods and prognosis were analysed. The pathological classification was haemangiolymphangioma, haemangioma, and lymphangioma in 8, 14, and 9 cases, respectively. The age of onset was 44-66 years, with no significant difference according to sex (P = 0.583); 32.26% (10/31) of patients had no noticeable symptoms, 37.5% (12/31) of patients had gastrointestinal bleeding, and 6.45% (2/31) of patients, all with lymphangioma, had intestinal obstruction. The lesions were located in and below the duodenum. Endoscopy showed colour differences. Both endoscopic and surgical treatments were safe and effective. The mean survival time was 57.06 ± 35.64 months. Regarding vascular tumours without typical symptoms, the main pathological classification is haemangioma. Vascular tumours are often clinically identified because of bleeding or obstruction and can be treated with endoscopy or surgery. Clinical follow-up is recommended because no invasive manifestations or instances of recurrence were observed.


Assuntos
Neoplasias Gastrointestinais/patologia , Neoplasias Vasculares/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Gerenciamento de Dados , Feminino , Trato Gastrointestinal/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Tumores Neuroendócrinos/patologia , Prognóstico , Taxa de Sobrevida , Adulto Jovem
8.
Indian J Pathol Microbiol ; 64(3): 541-544, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34341268

RESUMO

Intravascular papillary endothelial hyperplasia (IPEH) is a benign, reactive proliferation of endothelial cells within areas of thrombus. It most commonly occurs in the skin and subcutaneous tissue, with less than 40 cases reported in intracranial location. Ours is the first case report from India of IPEH in the cavernous sinus. A 45-year-old male presented with headache and decreased visual acuity. Magnetic resonance imaging (MRI) revealed a well-defined, homogeneously contrast-enhancing mass in the cavernous sinus. Postoperatively, examination of tissue showed organizing thrombus within the vessel wall along with delicate, acellular, pseudopapillary cores. The fibrin-rich connective tissue of these showed blue staining with Masson's trichrome stain. These were lined by a single layer of endothelial cells without evidence of atypia; no nuclear pleomorphism, hyperchromasia, atypical mitosis, or areas of necrosis were seen. Hence, it was diagnosed to be IPEH. Follow-up MRI revealed no residual disease and the patient is disease-free at 8 months. Recognition of this entity by pathologic examination is important to rule out angiosarcoma. Gross total resection is curative. Residual lesions have the potential for recurrence, requiring adjuvant therapy.


Assuntos
Seio Cavernoso/diagnóstico por imagem , Células Endoteliais/patologia , Hiperplasia/patologia , Neoplasias Vasculares/diagnóstico por imagem , Neoplasias Vasculares/patologia , Adulto , Criança , Feminino , Humanos , Recém-Nascido , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Adulto Jovem
10.
Am J Case Rep ; 22: e931386, 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34381010

RESUMO

BACKGROUND Intravenous leiomyomatosis (IVL) is a rare benign smooth muscle tumor originating in the uterus or in the uterine vessels. It is characterized by continuous intraluminal growth that may extend through iliac veins and inferior vena cava (IVC) to right chambers of the heart and pulmonary vasculature, leading to life-threatening complications. This case report describes an uncommon cause of non-thrombotic pulmonary embolism in young woman caused by extensive IVL. CASE REPORT A 39-year-old woman was admitted after multiple syncopal episodes. She was initially found to have a bilateral pulmonary embolism and large right atrial mass believed to be a thrombus. After an unsuccessful attempt to remove the thrombus with AngioVac (AngioDynamics, Latham, NY), subsequent sternotomy revealed a large pedunculated mass extending to the infra-hepatic IVC. Further abdominal imaging showed multiple uterine masses, with the largest about 17 cm, infiltrating the parauterine vessels and extending through the right iliac vein and inferior vena cava up to the right atrium. Pathology examination of the atrial mass revealed benign leiomyoma consistent with further pathology findings after hysterectomy. The pulmonary embolism was believed to be caused by tumor tissue, and anticoagulation was abandoned. Pulmonary nodule raised a suspicion of benign pulmonary metastases, but, fortunately, remained stable during follow-up and the patient had a successful recovery. CONCLUSIONS Available information about IVL is scarce. This tumor, although benign and rare, should be included in the differential diagnosis of cardiac tumors and non-thrombotic pulmonary emboli in women with predisposing risk factors, as potential complications are life-threatening.


Assuntos
Neoplasias Cardíacas , Leiomiomatose , Embolia Pulmonar , Neoplasias Uterinas , Neoplasias Vasculares , Adulto , Feminino , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/cirurgia , Humanos , Leiomiomatose/complicações , Leiomiomatose/cirurgia , Embolia Pulmonar/etiologia , Neoplasias Uterinas/complicações , Neoplasias Uterinas/cirurgia , Neoplasias Vasculares/complicações , Neoplasias Vasculares/cirurgia , Veia Cava Inferior/diagnóstico por imagem
11.
Zhongguo Gu Shang ; 34(8): 759-63, 2021 Aug 25.
Artigo em Chinês | MEDLINE | ID: mdl-34423621

RESUMO

OBJECTIVE: To explore the surgical method and safety of modified one stage posterior approach total en block spondylectomy combined with pedicle screw fixation and titanium mesh reconstruction for the treatment of invasive thoracic vascular tumor. METHODS: The clinical data of 12 patients with invasive thoracic vasculay tumor from December 2012 to May 2015 was retrospectively analyzed. There were 8 males and 4 females, aged from 40 to 62 years with an average of 51.2 years, the course of disease was 2 months to 8 years with an average of 3.4 years. The lesions involved vertebral bodies:1 case of T2, 4 cases of T4, 1 case of T5, 2 cases of T6, 2 cases of T8, and 2 cases of T10. According to Tomita classification, there were 3 cases of typeⅠ, 3 cases of typeⅡ, 1 case of type Ⅲ, and 5 cases of type Ⅳ. The Japanese Orthopaedic Association (JOA) score was 8.0±2.7 before operation. One patient with T10 lesions had sensory dyskinesia below the umbilicus, and the muscle strength of both lower limbs was grade Ⅰ-Ⅱ, and the others 11 patients were grade Ⅲ-Ⅳ. All 12 patients underwent one stage posterior approach total en block spondylectomy and the pedicle screw fixation combined with titanium mesh reconstruction under general anesthesia and continuous motor evoked potential (MEP) spinal cord electrophysiological monitoring throughout the operation. The operation time, intraoperative blood loss and transfusion, postoperative pain and recovery of spinal cord function, bone graft fusion, tumor recurrence and other complications were followed up. RESULTS: All the operations were successful. The average operation time, intraoperative blood loss and blood transfusion were 5.5 h (4.5 to 6.0 h), 1 850 ml (1 650 to 2 500 ml), 1 050 ml (600 to 1 500 ml), respectively. All 12 patients were followed up for 5 months to 2.5 years with an average of 21 months. Local pain and lower limb muscle strength were improved to varying, and the nerve compression symptoms disappeared. The JOA score at 6 months after operation was 12.0±3.4, which was statistically significant difference compared with the preoperative 8.0±2.7 (t=3.20, P<0.05). Titanium mesh bone grafts were all fused in phaseⅠ, with an average fusion time of 4.5 months (3 to 7 months). During the follow-up period, there was no tumor recurrence, loosening or breaking of nails, sinking and displacement of titanium mesh. CONCLUSION: Modified one stage posterior approach total en block spondylectomy is an ideal surgical method for the treatment of invasive thoracic vascular tumors, which has a safe, reliable and long lasting efficacy.


Assuntos
Neoplasias da Coluna Vertebral , Neoplasias Vasculares , Feminino , Humanos , Masculino , Recidiva Local de Neoplasia , Estudos Retrospectivos , Neoplasias da Coluna Vertebral/cirurgia , Coluna Vertebral
12.
Ophthalmologe ; 118(10): 1057-1062, 2021 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-34309716

RESUMO

Retinal tumors are a heterogeneous group of congenital and acquired lesions. In this review series the important retinal tumors are discussed and presented in two articles. In the first part of the article the most important vascular tumors of the retina are presented. Even with benign tumors visual symptoms, such as exudative retinal detachment occur, which often lead to irreversible visual impairments. Because visual symptoms are often a manifestation of systemic diseases, the ophthalmologist plays an important role in the accurate and early diagnosis of retinal tumors. This article reviews the most important clinical and diagnostic features of retinal vascular tumors in adults, their systemic associations and the literature on currently available treatment strategies.


Assuntos
Hemangioma , Descolamento Retiniano , Neoplasias da Retina , Neoplasias Vasculares , Adulto , Angiofluoresceinografia , Humanos , Retina , Neoplasias da Retina/diagnóstico , Neoplasias da Retina/terapia
13.
Cancer Sci ; 112(10): 3953-3961, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34327781

RESUMO

Intravascular large B-cell lymphoma is a rare disease of the large B cells characterized by selective growth in the lumina of small vessels in systemic organs. Since first reported in 1959, the difficulty of obtaining sufficient tumor cells from biopsy specimens has hampered the elucidation of its underlying biology. Recent progress using xenograft models and plasma cell-free DNA has uncovered genetic features that are similar to those of activated B-cell type diffuse large B-cell lymphoma, including MYD88 and CD79B mutations and frequent alterations in immune check point-related genes such as PD-L1 and PD-L2. Given the improvement in clinical outcomes and a higher risk of secondary central nervous system (CNS) involvement in the rituximab era, a phase 2 trial of R-CHOP combined with high-dose methotrexate and intrathecal chemotherapy as a CNS-oriented therapy has been conducted. This trial, the PRIMEUR-IVL study, has displayed good progression-free survival and a low cumulative incidence of secondary CNS involvement. Long-term follow-up within this trial is still ongoing. Further understanding of the pathophysiology of the disease and improvements in clinical outcomes are still needed.


Assuntos
Linfoma Difuso de Grandes Células B , Neoplasias Vasculares , Antimetabólitos Antineoplásicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Antígeno B7-H1/genética , Pontos de Checagem do Ciclo Celular/genética , Neoplasias do Sistema Nervoso Central/prevenção & controle , Ensaios Clínicos Fase II como Assunto , Ciclofosfamida/uso terapêutico , Doxorrubicina/uso terapêutico , Feminino , Previsões , Xenoenxertos , Humanos , Injeções Espinhais , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/genética , Linfoma Difuso de Grandes Células B/patologia , Masculino , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Transplante de Neoplasias , Prednisona/uso terapêutico , Proteína 2 Ligante de Morte Celular Programada 1/genética , Intervalo Livre de Progressão , Rituximab/uso terapêutico , Neoplasias Vasculares/diagnóstico por imagem , Neoplasias Vasculares/tratamento farmacológico , Neoplasias Vasculares/genética , Neoplasias Vasculares/patologia , Vincristina/uso terapêutico
15.
J Card Surg ; 36(10): 3889-3891, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34164844

RESUMO

Pulmonary artery intimal sarcomas (PAIS) are vascular sarcomas of mesenchymal origin and are exceedingly rare. Here, we detail a 57-year-old female who presents with worsening dyspnea and computed tomography scan findings consistent with a pulmonary embolus, however, upon examination in the operating room for emergent embolectomy, was found to have a PAIS. This case report highlights this rare illness and management decisions that can optimize care of these patients.


Assuntos
Embolia Pulmonar , Sarcoma , Neoplasias Vasculares , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/cirurgia , Sarcoma/diagnóstico por imagem , Sarcoma/cirurgia , Neoplasias Vasculares/diagnóstico por imagem , Neoplasias Vasculares/cirurgia
16.
Radiology ; 299(3): 730-735, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34029167

RESUMO

History A 26-year-old man presented with a 1-month history of chest pain, a palpable and painful right inguinal mass, and edema in the right lower extremity. One month earlier, he started to experience left chest pain with no cough. Pulmonary CT angiography (CTA) revealed a left lower lobe segmental pulmonary embolus. The local hospital made a diagnosis of pulmonary embolism. He received anticoagulants, and his chest pain was gradually relieved. At the time of current presentation, the patient was experiencing right lower extremity swelling and pain. Physical examination revealed a 4 × 3 cm palpable right inguinal mass with no redness. His medical history and family history were negative. The results of laboratory work-up were normal, with a d-dimer level of 0.16 mg/L fibrinogen equivalent units (reference range, <0.46 mg/L) and an international normalized ratio of 2.45 (therapeutic range, 2.0-3.0 for a patient taking warfarin), except the prothrombin time was 28.2 seconds (reference range, 9.6-12.8 seconds) and the activated partial thromboplastin time was 52.2 seconds (reference range, 24.8-33.8 seconds). Echocardiography, chest radiography, chest CT, and contrast-enhanced (CE) CT revealed no abnormalities. The patient underwent right lower extremity vascular conventional US (Philips IU22; Philips) with an L9-3 probe (3-9 MHz, venous condition) and contrast-enhanced US (1.5-2.0 mL, SonoVue; Bracco) with an intravenous bolus injection at the initial evaluation. Two days later, noncontrast and contrast-enhanced CT images of the lower abdomen (1.5 mL per kilogram of body weight, 300 mg/mL iomeprol, Iomeron; Bracco) were acquired for further evaluation.


Assuntos
Sarcoma Sinovial/diagnóstico por imagem , Neoplasias Vasculares/diagnóstico por imagem , Adulto , Meios de Contraste , Diagnóstico Diferencial , Veia Femoral/diagnóstico por imagem , Humanos , Veia Ilíaca/diagnóstico por imagem , Iopamidol/análogos & derivados , Masculino , Fosfolipídeos , Embolia Pulmonar/diagnóstico , Sarcoma Sinovial/cirurgia , Hexafluoreto de Enxofre , Neoplasias Vasculares/cirurgia
17.
A A Pract ; 15(6): e01478, 2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34043605

RESUMO

Primary leiomyosarcomas of the inferior vena cava (IVC) are rare sarcomas, none of which have been described in literature during a third-trimester pregnancy. Here, we describe the complex care of a patient at 30 weeks of gestation who presented to her obstetrician with shortness of breath and lower extremity swelling. She was found to have a 5.0 × 5.0 × 13 cm heterogeneous mass of her IVC, ultimately diagnosed as a leiomyosarcoma. She underwent a cesarean delivery under combined spinal epidural and a subsequent tumor resection and IVC reconstruction requiring multidisciplinary surgical and anesthetic care.


Assuntos
Leiomiossarcoma , Neoplasias Vasculares , Feminino , Átrios do Coração/cirurgia , Humanos , Leiomiossarcoma/cirurgia , Gravidez , Neoplasias Vasculares/cirurgia , Veia Cava Inferior/cirurgia
18.
J Investig Med High Impact Case Rep ; 9: 23247096211014687, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33969719

RESUMO

Primary pulmonary artery sarcomas (PPAS) are extremely rare tumors that are often mislabeled as pulmonary emboli (PE). PPAS usually involve the pulmonary trunk and are histologically classified as leiomyosarcoma, spindle cells sarcoma, fibrous histiocytoma, or undifferentiated sarcoma. Our case involved a 78-year-old man with an undifferentiated PPAS confined to the left pulmonary artery that was initially misdiagnosed as a PE. After a month-long delay in treatment in which the patient was prescribed warfarin, the correct diagnosis was made. Pulmonary artery endarterectomy and left lung pneumonectomy were performed, and he survived for 18 months before disease recurrence and death. Our case helps illustrate some of the clinical and radiographic findings that help distinguish PPAS from PE.


Assuntos
Sarcoma , Neoplasias Vasculares , Idoso , Humanos , Pulmão , Masculino , Recidiva Local de Neoplasia , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/cirurgia , Sarcoma/diagnóstico , Sarcoma/cirurgia , Neoplasias Vasculares/diagnóstico , Neoplasias Vasculares/cirurgia
20.
Chest ; 159(5): e337-e342, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33965159

RESUMO

CASE PRESENTATION: A 62-year-old man presented with a 3-month history of shortness of breath and a dry cough. He had a medical history of hypertension (without use of angiotensin-converting enzyme inhibitors), hyperlipidemia, depression, and 10-pack-years of cigarette smoking several decades ago. He was a limousine driver and denied any history of occupational high-risk exposures. The patient denied significant weight gain or weight loss, night sweats, fevers, hemoptysis, chest pain, or palpitations. He had a normal physical examination. Pulmonary function studies with a hemoglobin level of 12.9 gm/dL revealed normal spirometry, normal lung volumes, and moderately low diffusion capacity (56% of predicted). A 6-minute walk test showed mild desaturation (97% to 92% after 432 m). Stress echo revealed ejection fraction of 60% with no regional wall motion abnormalities, no evidence of impaired diastolic filling, estimated peak pulmonary artery pressure 35 to 40 mm Hg, and no valvular abnormalities with desaturation to 87% during the test. Extensive rheumatologic, infectious disease, and hypercoagulability workup were unremarkable. BAL was negative for malignancy, infection, or eosinophilic lung disease.


Assuntos
Artéria Pulmonar , Sarcoma/diagnóstico , Neoplasias Vasculares/diagnóstico , Tosse , Diagnóstico Diferencial , Dispneia , Evolução Fatal , Humanos , Masculino , Pessoa de Meia-Idade , Sarcoma/patologia , Fumantes , Neoplasias Vasculares/patologia
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