Description
A 62-year-old woman with diabetes presented with progressive exertional dyspnoea, chest pain and palpitation for several months. She had no history of leg oedema, fever, bodyweight change and general weakness. Therefore, she received associated exams at cardiovascular outpatient department. Transthoracic echocardiogram showed right atrium and ventricle dilatation with severe pulmonary hypertension. Besides, a thrombus-like mobile mass was noted at right ventricle and pulmonary artery (figure 1, video 1). Pulmonary embolism, as one of the life-threatening conditions, was our tentative diagnosis, and she was transferred to the emergency department. Chest CT showed multifocal filling defects at right ventricle, main pulmonary artery trunk and bilateral pulmonary arteries with several lung nodules (figure 2). Primary tumour or metastasis was our final impression by image study. Finally, the patient underwent surgery, which confirmed the mass to be pulmonary artery intimal sarcoma, not a large thrombus (
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