
RESUMO: O Sarcoma da Artéria Pulmonar é um tumor raro, apresentando-se com sinais e sintomas inespecÃficos, simulando por vezes o Tromboembolismo Pulmonar (TEP), o que torna o seu diagnóstico difÃcil e tardio.A este propósito os autores apresentam um caso de um homem de 59 anos, ex-fumador, internado por dispneia de esforço, toracalgia e sintomas gerais.Portador de uma radiografia e TAC torácicas, ambas evidenciando imagens sugestivas de Trombose da Artéria Pulmonar Direita.Analiticamente e antes de qualquer terapêutica: Inibidor Lúpico â e anticardiolipina IgM +.Presumido diagnóstico inicial de TEP crónico em doente com provável SÃndroma de Hipercoaguabilidade, iniciou terapêutica hipocoagulante, com melhoria.Reinternado 2 meses após alta por agravamento clÃnico e radiológico. Proposto e aceite para Tromboendarterectomia Pulmonar, sob circulação extracorporal e paragem cardiocirculatória em hipotermia profunda (18 ºC). Durante a cirurgia constatou-se a presença de «mega-artérias pulmonares» preenchidas por massa trombosada que se estendia à s ramificações arteriais segmentares. Após a exérese dessa massa houve necessidade de realizar Pneumectomia direita por hemorragia progressiva incontrolável.Veio a falecer ao 7.º dia de pós-operatório, por ARDS em pulmão único.Resultado Anatomopatológico: Sarcoma da Artéria Pulmonar com Metastização Pulmonar e Pleural.REV PORT PNEUMOL IX (1): 41-51 ABSTRACT: Primary Pulmonary Artery Sarcoma is a rare entity, which shares some clinical features with Thromboembolic Pulmonary Disease (TEPD), complicating differential diagnosis.The authors report a Clinical Case of a Primary Pulmonary Artery Sarcoma in a 59 years old man, admitted with a history of dyspnoea on exertion, chest pain and general symptoms. Chest X-ray, Computed Tomography Scan, Angiographies and Magnetic Resonance Imaging suggested TEPD.Blood Analysis performed before anticoagulation therapy: Lupus Anticoagulant - and Ig M Anticardiolipin+.Our presumptive initial diagnosis was TEPD in a patient with a hypercoagulable state.Intravenous heparin was started, with some clinical improvement but 2 months later he was readmitted, due to clinical and radiological deterioration. Pulmonary Thromboendarterectomy was considered but a right pneumonectomy was necessary because of bleeding. He died of ARDS in a single lung in the 7 th day after surgery. Pathology revealed pulmonary artery sarcoma with pulmonary and pleural metastases.REV PORT PNEUMOL IX (1): 41-51 Palavras-chave: Sarcoma da Artéria Pulmonar, Tumores Vasculares, Key-words: Pulmonary Artery Sarcoma, Vascular Tumour
Diseases of the respiratory system, RC705-779
Diseases of the respiratory system, RC705-779
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