Angiosarcoma of the aorta: Report of a case and review of the literature

Seelig, Matthias H.; Klingler, Paul J.; Oldenburg, W. Andrew; Blackshear, Joseph L.

doi:10.1016/s0741-5214(98)70104-1

Cited by 105 publications

(88 citation statements)

References 58 publications

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“…Fewer than 140 aortic sarcomas have been reported in the literature, with only 10 defined as angiosarcoma of the infrarenal aorta [1][2][3]. The median survival rate of patients with aortic sarcomas has been reported to be 7 months, which was explained by a late diagnosis combined with inadequate surgical resection [1].…”

Section: Discussionmentioning

confidence: 99%

“…The median survival rate of patients with aortic sarcomas has been reported to be 7 months, which was explained by a late diagnosis combined with inadequate surgical resection [1]. The imaging findings are frequently nonspecific and in most published cases did not allow a definitive preoperative diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasound, CT, magnetic resonance imaging, and magnetic resonance angiography have been used to diagnose aortic sarcomas [1,[6][7][8][9]; however, the correct diagnosis has rarely been made. To our knowledge, this is the second report to document the use of conventional aortography for diagnosing an intimal sarcoma of the aorta before autopsy.…”

Section: Fig 1 Transverse (Top Left) and Sagittal (Top Right) Ct Scmentioning

confidence: 99%

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Primary sarcoma of an abdominal aortic aneurysm

et al. 2005

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Primary tumors of the aorta are extremely rare and the diagnosis is made most often after surgery or autopsy. Because clinical symptoms of abdominal sarcoma are similar to those of occlusive or aneurysmal disease, aortic sarcomas are frequently mistaken for these lesions. The imaging findings are frequently nonspecific and therefore do not allow a definitive preoperative diagnosis. We report a case of an epithelioid angiosarcoma in the vessel wall of an abdominal aortic aneurysm.Keywords : abdominal ortic aneurysm ; Sarcoma ; Aortography ; Diagnosis Primary tumors of the aorta are extremely rare and almost always malignant. Most aortic tumors are often confused for occlusive or aneurysmal atherosclerotic lesions and are diagnosed mainly after surgery or autopsy. We report a case of an epithelioid angiosarcoma in the vessel wall of an abdominal aortic aneurysm (AAA). Case reportA 50-year-old man was referred to our department with a known AAA that was 46 mm in diameter and a wall thrombus diagnosed by abdominal computed tomography (CT; Fig. 1A,B). The patient complained of left intermittent claudication, lumbar pain, sexual impotence, and significant weight loss (25 kg) in the preceding year. These physical problems were associated with psychological disorders. Aortography confirmed the diagnosis of a small aneurysm with subocclusion of the left common iliac artery (Fig. 1C). An irregular plaque of the infrarenal aorta was also observed. Aortic surgery was done to alleviate the occlusive lesions of the iliac artery and the small AAA. Aortotomy revealed an unusual cystic wall thrombus at the level of the terminal aorta and left common iliac artery. A sample of the thrombus including the aortic wall was excised for histologic analysis. An aortobiiliac bifurcated graft was inserted.The histologic investigation showed irregular, polymorphic large cells grouped in poorly cohesive sheets (Fig. 2). Atypical mitotic figures were observed. These cells showed positive immunohistologic staining for vimentin, CD31, CD34, and factor VIII but were negative for epithelial markers and smooth muscle actin. This pattern was suggestive of an epithelioid angiosarcoma.Postoperatively, a whole-body positron emission tomography, scintigraphy and CT were performed to search for a primary lesion and potential metastasis. Intense fluorine 18 fluorodeoxyglucose ( 18 F-FDG) uptake was observed at the level of the terminal aorta and at the level of right and left femurs, iliac artery, and vertebral body (Fig. 3). CT and scintigraphy demonstrated several lytic lesions in the bones of the lower part of the body (vertebral body L4, right and left iliac bones, sacrum, neck of the right femur, patella, and condyle of the left iliac bone). These osteoclastic lesions and some erosions were suggestive of metastases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Fig 1 Transverse (Top Left) and Sagittal (Top Right) Ct Scmentioning

confidence: 99%

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Primary sarcoma of an abdominal aortic aneurysm

et al. 2005

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“…The first case report was given by Brodowski in 1973 [1]. A metaanalysis of 87 cases until 1998 reported 28 female patients and 59 male patients with a median age of 60 years (range 3 months to 82 years) [2]. Thirty-nine tumors (45%) were located in the thoracic aorta, 39 (45%) in the abdominal portion and nine (10%) in the thoracoabdominal aorta.…”

Section: Discussionmentioning

confidence: 99%

“…It arises from intimal endothelial cells (intima type) and myofibroblastic cells (mural type). Only a few cases have been reported so far [1][2][3][4][5][6][7][8].…”

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confidence: 99%

Primary angiosarcoma of the abdominal aorta: multi-row computed tomography

2009

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Primary angiosarcoma of the aorta is a rare tumor. The symptoms resemble those of atherosclerotic occlusive disease, and the radiomorphologic pattern is often nonspecific. In most published cases, the malignant vascular obstruction was diagnosed histopathologically after surgical vascular reconstruction. We report on interventional and CT-angiographic features of an abdominal aortic angiosarcoma, observed in a 71-year-old patient. The polyploid intimal alteration is clearly depicted on CT images. Morphology and the segmental obstruction of the aortic lumen without aneurysmal or extensive atherosclerotic mural changes should lead to the differential diagnosis of an intravascular malignancy.

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