2022 Volume 44 Issue 6 Pages 426-431
Background. Pleural angiosarcoma is a rare disease that is difficult to diagnose, shows rapid growth, and has a poor prognosis. Case. A 73-year-old man with left pleural effusion and a history of asbestos exposure was referred to our hospital. Thoracoscopy under local anesthesia was performed, revealing diffuse, rough pleural thickening with scattered white protruded lesion. A pleural biopsy did not lead to a definitive diagnosis. Four months later, the left pleural effusion had massively increased on repeated thoracoscopy. Pleural bleeding and numerous irregular red tumors were observed in the thoracic cavity. A pleural biopsy revealed proliferation and invasion of CD31-positive spindle cells, which turned out to be angiosarcoma. This patient did not respond to outpatient chemotherapy and died six months after the diagnosis. Conclusion. We encountered a rare case of primary pleural angiosarcoma in which rapid pleural changes were visualized by thoracoscopy. It is difficult to suspect or diagnose angiosarcoma based on early lesions in such cases, so a surgical biopsy should be considered.