title: Hemangiosarcoma after endovascular aortic aneurysm repair.
abstract: OBJECTIVE
  To report a rare case of hemangiosarcoma after endovascular aneurysm repair (EVAR).
  
  
  METHODS
  A 50-year-old man with Klinefelter syndrome presented 5 years after EVAR with a mass at the infrarenal aorta outside the stent-graft. Radiomorphologic and clinical signs were misleading because there had been evidence of an inflammatory process for more than a year. The stent-graft with the surrounding aorta was removed and replaced by a conventional tube graft. Systemic chemotherapy followed. The tumor recurred after 12 months, with pulmonary metastases and tumor embolic occlusion of his left femoral artery. Thrombectomy was performed, and a second course of chemotherapy was administered. The patient died 24 months after the conversion procedure.
  
  
  CONCLUSIONS
  Morphological changes of the aneurysm wall seen on computed tomographic scans of EVAR patients may not be incidental or signs of infection; rather, a malignant tumor of the aorta or lymphatic disease, although rare, have to be taken into consideration as well.
authors.affiliation: Department of Vascular Surgery, St. Franziskus Hospital, Münster, Germany. Thomas.Umscheid@sfh-muenster.de
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Umscheid
authors.forename: Guido
authors.initials: G
authors.lastname: Rouhani
authors.forename: Thorsten
authors.initials: T
authors.lastname: Morlang
authors.forename: Thomas
authors.initials: T
authors.lastname: Lorey
authors.forename: Peter-Josef
authors.initials: PJ
authors.lastname: Klein
authors.forename: Peter
authors.initials: P
authors.lastname: Ziegler
authors.forename: Wolf J
authors.initials: WJ
authors.lastname: Stelter
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D017809:Fatal Outcome; D006394:Hemangiosarcoma / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007713:Klinefelter Syndrome / Q000150:complications; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D015607:Stents; D014057:Tomography, X-Ray Computed
chemical_list: D011093:Polyethylene Terephthalates