Primary pleural angiosarcoma is an exceptionally rare malignancy of pleura originating from the vascular endothelial cells. Here, we present a 70-year-old African-American female who presented with 1-month history of dyspnea on exertion, loss of appetite, and loss of weight along with left-sided pleuritic chest pain. Evaluation revealed hemorrhagic pleural effusion in the left pleural cavity. Computed tomography of the chest performed after therapeutic thoracocentesis revealed left upper lobe lung mass along with multiple nodules in right lung. Mass was biopsied at video-assisted thoracoscopy. Histopathology was consistent with high-grade angiosarcoma. Endothelial origin of the tumor cells was confirmed with positive immunohistochemical staining with CD31 antibodies. Our patient was diagnosed with primary pleural angiosarcoma metastatic to the lung. She opted for palliative care and had a rapidly declining clinical course and expired within 5 weeks of the diagnosis. Here, we present a case report and review the relevant literature.

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