CTICasesPulmonary Artery Intimal Sarcoma
Imaging findings
Initial contrast-enhanced chest CT demonstrates a large, expanding, and lobulated soft tissue mass originating in the pulmonary valve annulus and extending along the main and bilateral branch pulmonary arteries. Following surgical resection and valve replacement, a repeat cardiac CT performed several months later reveals rapid, massive local recurrence of the tumor within the right ventricular outflow tract (RVOT) and pulmonary arteries, with extension into the pericardium.
Key takeaways
Pulmonary artery intimal sarcoma is an extremely rare and highly aggressive malignancy that arises from the vessel wall. It is frequently misdiagnosed as acute pulmonary embolism or chronic thromboembolic pulmonary hypertension (CTEPH); key imaging features that help distinguish sarcoma include expansion of the pulmonary artery lumen, local invasion into adjacent mediastinal structures, and rapid recurrence post-intervention.
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