Use of recombinant activated factor VII for bleeding following resection of mediastinal angiosarcoma

Sarcomatous lesions of the mediastinum usually present as aggressive and multicentre masses often attached to adjoining structures including heart and lungs. A forty one year male diagnosed with sarcomatous lesion in mediastinum presented for biopsy through mid-sternotomy later confirmed as angiosarcoma on histopathology. Patient bled excessively after surgery and required reopening of the chest. However, bleeding could not be controlled with reopening, blood products and packing of the mediastinal cavity. Bleeding could only be controlled by using recombinant activated factor VII as rescue therapy without any adverse effects.