Leiomyosarcoma of the pulmonary artery - a diagnostic chameleon

A 60-year-old woman suffered from right-sided pain in the back and dyspnea suspicious for chronic pulmonary thromboembolism. Since computed tomography demonstrated a progressive filling defect within the left pulmonary artery, a transvenous biopsy was taken, which demonstrated malignant sarcoma, The patient underwent left-sided pneumonectomy with the aid of cardiopulmonary bypass. In case of a suspected 'chronic' pulmonary embolism with occlusion of a main pulmonary artery, as may be seen with imaging techniques, a sarcomatous disease should be ruled out, especially if there are no coagulation disorders, and the tumor obliterations progress in serial CT scans despite effective anticoagulation. (C) 2001 Elsevier Science BN. All rights reserved.