Aortic Angiosarcoma: A Rare Cause for Leaking Thoracic Aneurysm

• DOI: 10.1007/s00270-009-9776-3
• Publication Date: 2010-02-09T16:16:32Z
• Authors: S. L. Hales; R. Locke; A. Sandison; M. Jenkins; M. Hamady
• Keywords: Male; Hematoma; Aortic Aneurysm, Thoracic; Endoleak; Biopsy; Angioplasty; Hemangiosarcoma; Aortic Diseases; Kidney; Aortography; 3. Good health; Diagnosis, Differential; Blood Vessel Prosthesis Implantation; 03 medical and health sciences; Imaging, Three-Dimensional; 0302 clinical medicine; Ischemia; Disease Progression; Image Processing, Computer-Assisted; Humans; Bone Marrow Neoplasms; Aneurysm, Infected; Magnetic Resonance Angiography

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.