Abstract
Introduction
Angiosarcoma is a very rare and aggressive vascular malignant tumor with origin in the vascular and lymphatic endothelium. It can be located in any part of the body, however pulmonary location is very infrequent. Hemoptysis can be the revealing symptom in these cases.
Presentation of the case
We present the case of a 74 year old male patient admitted in our clinic for prolonged cough and hemoptysis after being discharged from the maxillofacial clinic where he was admitted for drainage of dental abscesses, the patient being totally edentulous at the time of the presentation. He also presented aggravation of a chronic left shoulder pain in the past 2 months.
Multiple investigations were required because of the uncertain tumoral aspect shown on the CT scan and the lack of endobronchial expression of the tumor. Following these procedures, an upper right cervico-mediastinal tumor and a left osteolytic scapular tumor were detected. The diagnosis was confirmed by the ultrasound-guided biopsy of the cervico-mediastinal formation. The evolution was towards the appearance of a spontaneous right hemothorax and severe anemia with progressive worsening and death in the Oncology department approximately 2 months after the initial presentation.
Discussions
We presented the case of a patient with persistent hemoptysis with the initial suspicion of bronchopneumonia, in which, following further investigations, extrapulmonary angiosarcoma was identified, with 2 locations, cervico-mediastinal and bone location (scapular) but without histopathological confirmation of the lung lesion. Given the risk of massive hemoptysis, invasive bronchoscopic procedures were avoided.
Conclusion
Angiosarcoma is a very rare pulmonary malignant tumor and a rare cause of hemoptysis with a difficult diagnostic process.