Chondrosarcoma presenting as dyspnea in a 19-year-old man: a case report

Abstract

IntroductionAcute pulmonary embolism has varied presentations ranging from asymptomatic, incidentally discovered emboli to massive embolism, causing immediate death. Tumor embolism is a rare but unique complication of malignancies. This uncommon catastrophe of a malignant tumor in a young patient, culminating as a pulmonary embolism, is being reported for the first time.Case presentationA 19-year-old Asian man presented to the emergency service at our hospital with acute onset dyspnea. His clinical examination led to the suspicion of an acute pulmonary embolism with a lower lumbosacral radiculopathy. A magnetic resonance imaging scan of the pelvis demonstrated a chondrosarcoma arising from the right iliac wing, eroding into the common iliac vein and creeping up the inferior vena cava to lodge in the pulmonary artery, thus producing a saddle embolus.ConclusionThe importance of exploring for malignancies in the event of an idiopathic pulmonary embolism is highlighted. Early detection of such malignancies can substantially affect the outcome in young patients.

Chondrosarcoma Presenting as a Saddle Tumor Pulmonary Embolism

“…Tumor embolism occurs most often with breast, gastric, and lung carcinomas . This case report is the first reported case in the United States of a tumor pulmonary embolism from a chondrosarcoma, although a case has previously been reported from India in 2011 . The reported case from India was of a 19‐year‐old patient who, similar to the patient in this report, presented with acute respiratory distress and right heart dysfunction and underwent a pulmonary embolectomy .…”

“…This case report is the first reported case in the United States of a tumor pulmonary embolism from a chondrosarcoma, although a case has previously been reported from India in 2011 . The reported case from India was of a 19‐year‐old patient who, similar to the patient in this report, presented with acute respiratory distress and right heart dysfunction and underwent a pulmonary embolectomy . The patient survived the surgery as well as the perioperative period and was treated with adjuvant chemotherapy for metastatic foci to the right iliac wing and spine.…”

“…The optimal type of surgical management depends upon histologic grade, location, and tumor extent. The goal of surgery is complete excision while minimizing functional disability . Median survival for chondrosarcoma with lung metastases is 7.5 months …”

An Unusual Cause of Tree-in-Bud Pattern: Pulmonary Intravascular Tumor Embolism Caused by Chondrosarcoma

“…This phenomenon occurs most frequently in patients with lung, gastrointestinal, liver, breast, and uterine neoplasia [4]. Few cases of chondrosarcoma causing tumor embolism have been reported, and the diagnosis was delayed in most instances [5][6][7].…”

Chondrosarcoma presenting with pulmonary embolism in a 9-year-old girl: a case report

“…Adult autopsy studies estimate that the incidence of pulmonary tumour embolism is between 3% and 26% among patients with solid tumours, most commonly associated with breast, stomach, and lung carcinomas, but rarely chondrosarcoma. 10…”