DOI QR코드

DOI QR Code

전이성 연골육종에 의한 폐동맥색전증 1예

A Case of Pulmonary Embolism Due to Metastatic Chondrosarcoma

  • 장덕현 (세종병원 내과, 세종의학연구소) ;
  • 최락경 (세종병원 내과, 세종의학연구소) ;
  • 함의근 (세종병원 내과, 세종의학연구소) ;
  • 심원흠 (세종병원 내과, 세종의학연구소) ;
  • 채명준 (세종병원 내과, 세종의학연구소) ;
  • 이수연 (세종병원 내과, 세종의학연구소) ;
  • 현주용 (세종병원 내과, 세종의학연구소)
  • Jang, Duck Hyun (Department of Internal Medicine and Sejong Medical Research Institute, Sejong General Hospital) ;
  • Choi, Rak Kyeong (Department of Internal Medicine and Sejong Medical Research Institute, Sejong General Hospital) ;
  • Ham, Eokewn (Department of Internal Medicine and Sejong Medical Research Institute, Sejong General Hospital) ;
  • Sim, Won-Heum (Department of Internal Medicine and Sejong Medical Research Institute, Sejong General Hospital) ;
  • Chae, Myung Joon (Department of Internal Medicine and Sejong Medical Research Institute, Sejong General Hospital) ;
  • Lee, Soo Youn (Department of Internal Medicine and Sejong Medical Research Institute, Sejong General Hospital) ;
  • Hyun, Jooyong (Department of Internal Medicine and Sejong Medical Research Institute, Sejong General Hospital)
  • 발행 : 2013.01.01

초록

폐동맥 혈전색전증으로 내원하는 환자에서 항혈전치료 및 항응고치료 시행 이후 치료 효과에 대한 적절한 평가가 필요하며, 치료에 대한 적절한 반응을 보이지 않을 경우, 종양 색전증 등의 다른 원인에 대한 규명이 필요할 것으로 사료된다.

Acute pulmonary embolism is considered a cardiovascular emergency and is one of the most important causes of morbidity and mortality in hospitalized patients. Tumor embolism is a rare and unique complication of malignancies, and detached thrombi or tumors may cause massive pulmonary embolism in patients with malignancies. The identification of the type of pulmonary embolism is critical because treatment and prognosis vary considerably. We report an unusual presentation of a tumor embolism that was misdiagnosed as a pulmonary thromboembolism in a young woman. The patient was initially treated with the anti-coagulants warfarin and aspirin, but her symptoms were aggravated after two months and she required emergency surgery. Histology revealed a pulmonary embolism due to metastatic chondrosarcoma. Following surgery, her condition deteriorated, and she did not survive. This case highlights the need to investigate the cause of pulmonary embolism should the patient not respond to anti-coagulatant therapy.

키워드

참고문헌

  1. Kim YM, Park JS, Kim U, et al. Differential diagnosis of tumor embolism with thromboembolism using positron emission tomography. Korean J Med 2011;80:659-660.
  2. Cox JE, Chiles C, Aquino SL, Savage P, Oaks T. Pulmonary artery sarcomas: a review of clinical and radiologic features. J Comput Assist Tomogr 1997;21:750-755. https://doi.org/10.1097/00004728-199709000-00018
  3. Roberts KE, Hamele-Bena D, Saqi A, Stein CA, Cole RP. Pulmonary tumor embolism: a review of the literature. Am J Med 2003;115:228-232. https://doi.org/10.1016/S0002-9343(03)00305-X
  4. Shields DJ, Edwards WD. Pulmonary hypertension attributable to neoplastic emboli: an autopsy study of 20 cases and a review of literature. Cardiovasc Pathol 1992;1:279-287. https://doi.org/10.1016/1054-8807(92)90038-P
  5. Gelderblom H, Hogendoorn PC, Dijkstra SD, et al. The clinical approach towards chondrosarcoma. Oncologist 2008;13:320-329. Erratum in: Oncologist 2008;13:618. https://doi.org/10.1634/theoncologist.2007-0237
  6. Leung DY, Seah PW, Lee LC, Cranney GB, Walsh WF. Embolic chondrosarcoma: an unusual cause of pulmonary embolism. Am Heart J 1993;126(3 Pt 1):732-734. https://doi.org/10.1016/0002-8703(93)90434-B
  7. Yoshida K, Miyashita N, Nakajima M, Niki Y, Matsushima T. A case of sternal chondrosarcoma with multiple pulmonary embolisms. Nihon Kokyuki Gakkai Zasshi 2002;40:166-170.
  8. Chandrasekharan R, Bhagavaldas MC, Mathew AJ. Chondrosarcoma presenting as dyspnea in a 19-year-old man: a case report. J Med Case Rep 2011;5:150. https://doi.org/10.1186/1752-1947-5-150
  9. Park K, Kwon JB, Lee JH, et al. Surgical treatment of pulmonary artery sarcoma: one case report. Korean J Thorac Cardiovasc Surg 2004;37:597-600.
  10. Walker RH, Goodwin J, Jackson JA. Resolution of pulmonary embolism. Br Med J 1970;4:135-139. https://doi.org/10.1136/bmj.4.5728.135