Aortic angiosarcoma: a rare cause for leaking thoracic aneurysm.
Primary malignant tumours of the aorta are rare. They present with aneurysm formation, arterial occlusion, and embolic phenomenon. We report the case of a 56-year-old man whose initial presentation and investigations lead to emergency endovascular stenting of a descending thoracic aneurysm with a contained leak. Initial response was favourable, yet the patient presented again with worsening symptoms. The circum-aortic haematoma expanded by 50% on subsequent imaging, but no endoleak was identified. When altered bone marrow signal was identified on magnetic resonance imaging, the possibility of malignancy was considered. A metastatic skin lesion was then biopsied, which demonstrated morphological and immunohistochemical features consistent with metastases from a pleomorphic sarcoma of the aorta.
St. Mary's Hospital, Imperial College Healthcare NHS Trust, London W2 1NY, UK. sarah.hales@imperial.nhs.uk
S L
SL
Hales
R
R
Locke
A
A
Sandison
M
M
Jenkins
M
M
Hamady
D000785:Aneurysm, Infected / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D017130:Angioplasty; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D001018:Aortic Diseases / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D001027:Aortography; D001706:Biopsy; D019917:Blood Vessel Prosthesis Implantation; D019046:Bone Marrow Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary; D003937:Diagnosis, Differential; D018450:Disease Progression; D057867:Endoleak / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D006394:Hemangiosarcoma / Q000150:complications / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D006406:Hematoma / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D007668:Kidney / Q000098:blood supply; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000473:pathology; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary; D015607:Stents; D013904:Thoracic Vertebrae; D014057:Tomography, X-Ray Computed; D019043:Vascular Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery