Intimal sarcoma of the pulmonary artery

Intimal sarcoma of the pulmonary artery is an extremely rare type of malign ant tumor of the large vessels. Despite systematic diagnostics, distinguish ing between pulmonary emboli and tumors is difficult. We report a patient w ho was referred because of suspected embolic occlusion of the pulmonary art ery. The operation was started with the intention of performing a pulmonary artery thromboendarterectomy; however, intraoperative histology revealed a malignant mesenchymal tumor. Therefore, the left lung was resected with th e use of extracorporeal circulation, and the pulmonary trunk and right pulm onary artery were reconstructed. A solitary right lung metastasis was resec ted 3 months later using stapling devices. Complete surgical resection is t he treatment of choice for patients with sarcoma of the pulmonary arteries. Surgical therapy often includes extensive reconstructive measures. Since, thromboembolic obstruction cannot be excluded preoperatively, patients with this type of disease should be treated at centers experienced with the bro ad spectrum of pulmonary artery surgery.