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Ann Thorac Surg 2006;82:2303
© 2006 The Society of Thoracic Surgeons

Images in Cardiothoracic Surgery

Giant Metastatic Endometrial Sarcoma to the Right Lung

Michael K.Y. Hsin, FRCS, Anthony P.C. Yim, MD*

Division of Cardiothoracic Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong

* Address correspondence to Dr Yim, Department of Surgery, Division of Cardiothoracic Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong (Email: yimap{at}cuhk.edu.hk).

A 46-year-old woman with a history of endometrial sarcoma underwent hysterectomy, bilateral salpingo-oophorectomy, and radiotherapy. She remained well clinically during follow-up. However, 18 months later she complained of shortness of breath and chest discomfort. A chest roentgenogram revealed a massive right pleural effusion and mediastinal shift to the left (Fig 1). A computed tomographic scan of the thorax confirmed a heterogeneous mass measuring 10 x 15 x 18 cm with a large pleural effusion in the right hemithorax causing compression of the right lung and a mediastinal shift to the left (Fig 2). On positron emission tomography, the lesion had a standard uptake value maximum of 6.35 (Fig 3). No other positron emission tomographic positive lesion was seen. The findings were consistent with pleural metastasis.


Figure 1
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  		Fig 1.
 

Figure 2
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  		Fig 2.
 

Figure 3
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  		Fig 3.
 
She underwent elective right pneumonectomy through a median sternotomy with a right thoracotomy extension. A 2.2 kg pneumonectomy specimen with adjoining tumor was delivered. Histology confirmed a high-grade sarcoma. Postoperatively she made an uneventful recovery and was discharged home on postoperative day 11.





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