YO31 - Primary pulmonary sarcoma

Case summary

A 66-year-old male presented with left-sided pleuritic chest pain, common weak for 2 months and progressively increasing shortness of breath with dry cough for 1.5 months.On general survey, mild pallor was present, but there were no clubbing and palpable cervical and axillary lymph node. An X-ray showed a shadow in the left chest. The shadow of the heart was shifted to the right. Bronchoscopy showed compression of segmental bronchus of the left upper lobe bronchus. CT of the chest reveals a nodular pleura-based mass, which size was about 12.5х18.0х18.0 sm with effusion in the left pleural cavity. Around the nodular pleura-based mass were infiltrative changens. The histological analysis of tru-cut biopsy showed that there was fibrotic mesothelioma with necrosis or carcinoid. The patient underwent right upper lobectomy of lung with negative margins. During operation we saw that half of left pleural cavity was occupied by gigantic tumor, which size was 25x20x18 sm. Surface was bumpy, it had capsule, thick texture. There were effusion (150ml) in the left pleural cavity. The root of the lung, pericardium, thoracic part of aorta, diaphragm were free. The tumor was grew from right upper lobe (S5). The histological analysis after operation of this tumor showed that it was round cell sarcoma. After surgery, six cycles of adjuvant chemotherapy with ifosfamide and doxorubicin were given. Postadjuvant chemotherapy patient is kept on regular follow-up.

Clinical trial identification

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