ArticleFrontiers in oncology2026
Primary intimal sarcoma of the pulmonary artery misdiagnosed as acute pulmonary embolism: a case report.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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5 authors.
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Abstract
Primary intimal sarcoma is a rare malignant mesenchymal tumor arising from the vascular intima. Primary intimal sarcoma of the pulmonary artery (PAIS) is even rarer. Owing to the substantial overlap in clinical manifestations and imaging findings with pulmonary embolism (PE), this condition is frequently misdiagnosed in clinical practice, resulting in delays in appropriate treatment. This case report describes a 47-year-old man who presented with exertional dyspnea. Computed tomography pulmonary angiography revealed filling defects in the pulmonary arteries, leading to an initial diagnosis of acute PE. The patient subsequently underwent emergency percutaneous catheter-directed pulmonary artery thrombus aspiration, after which his symptoms improved significantly. One week postoperatively, histopathological examination of the retrieved specimen confirmed the diagnosis of poorly differentiated intimal sarcoma. Subsequent whole-body ^18F-fluorodeoxyglucose positron emission tomography-computed tomography revealed multiple pulmonary metastases. The patient subsequently received combination chemotherapy with doxorubicin and ifosfamide. Six months after the initiation of chemotherapy and targeted therapy, a contrast-enhanced chest CT scan revealed that the primary tumor had shrunk compared with its pre-treatment size. This case highlights the challenges in differentiating PAIS from PE and underscores the critical role of standardized imaging evaluation and histopathological examination in reducing misdiagnosis and establishing a definitive diagnosis. In addition, this study explores auxiliary diagnostic strategies to reduce the misdiagnosis rate of PAIS and discusses a potentially feasible and novel individualized minimally invasive surgical method in order to optimize the diagnostic and therapeutic strategies in clinical practice.
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