Massive osteolytic bone metastases from a primary aortic sarcoma: A case report

Patel, K. R.; Niazi, Tariq; Griffiths, Ann; Hardy, G. J.; Maclaren, Charles A.N; Reid, Ian N.

doi:10.1016/s0046-8177(97)90207-0

Cited by 15 publications

(7 citation statements)

References 2 publications

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“…The patient remains well 4 months after the operation. The clinical and histological pictures of our reported cases showed the characteristics of leiomyosarcomas of the great vessels described in earlier papers reviewing relatively large series of cases [3][4][5]. …”

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confidence: 59%

Primary intimal type leiomyosarcoma with rhabdomyosarcomatous differentiation of the thoracic aorta

Székely

Kulka

2000

Virchows Archiv

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Sirs: We have read the paper by Clelia Miracco et al. [1], reporting a case of a primary intimal type leiomyosarcoma with rhabdomyosarcomatous differentiation of the thoracic aorta, with great interest. We would like to add two additional cases to the still relatively small number of sarcomas of the great vessels (thoracic aorta, and inferior vena cava ([IVC]) described in the English literature in the last century [1]. We have diagnosed these cases in our department during the last 2 years. One patient was female; her main complaint was severe back pain, and a CT scan revealed an aneurysm of the thoracic aorta with imminent rupture. Urgent resection of the aorta had to be performed, since the aneurysm ruptured while the patient was waiting for a scheduled operation. Microscopic examination revealed an epithelioid leiomyosarcoma (LMSC) in the vessel wall, which was almost evenly distributed in all layers, the main part being at the site of the rupture, and in the immediate vicinity (Figs. 1, 2). The diagnosis was confirmed by positive immunohistochemical reactions for smooth muscle actin (SMA; Fig. 3), desmin, and vimentin antibodies. Following the histological diagnosis, a meticulous search for a primary tumour was unsuccessful. Finally, a primary LMSC of the aorta was diagnosed. The patient died 5 months later of widespread metastases (vertebrae, pelvis). The rapid clinical deterioration and the quick development of metastases indicate an intimal-type LMSC of the aorta; however, no autopsy was performed.The other case was in a male patient with low back pain. The CT scan revealed a huge retroperitoneal tumour, probably of adrenal gland origin. A small piece of the tumour was sent for intraoperative frozen examination. On the basis of the clinical information provided and the histological picture (whorling of bland-looking tumour cells with elongated eosinophilic cytoplasm, no mitoses, no necrosis), a probably benign nerve sheath tumour of the adrenal gland was diagnosed. The surgeon later reported that the tumour had no association with the adrenal gland and had an easily removable retroperitoneal margin, but was attached to the wall of the IVC, so that only a part of the tumour was resected. Macroscopically, a greyish-white firm lobulated tumour with areas of necrosis was seen, with an advancing margin on one side. It was evident that the resection line traversed the mass. No association with the resected adrenal gland was found. On histological examination part of the tumour showed a completely benign picture, consistent with the findings observed on the frozen sections. A few sections showed rather dedifferentiated areas with focal necrosis and numerous typical and atypical mitoses, striking indications of an obviously malignant neoplasm (Fig. 4). Immunohistochemical reactions showed strong positivity for SMA Fig. 5), desmin, and vimentin. Finally, a partly well-differentiated leiomyosarcoma, originating most probably from the wall of the IVC, was diagnosed. The patient remains well 4 months after the operat...

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confidence: 59%

Primary intimal type leiomyosarcoma with rhabdomyosarcomatous differentiation of the thoracic aorta

Székely

Kulka

2000

Virchows Archiv

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“…Including our series with the 4 presented cases, which is the largest single center experience published, 100 cases of primary malignant tumors of the aorta have been described. [1][2][3][4][5][6][7][8][9][10] Most of the cases described were sarcomas without further classification (n ϭ 24), and malignant fibrous histiocytoma was the second most common histologic entity (n ϭ16).…”

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confidence: 99%

“…The clinical presentation of patients with malignant tumors of the aorta is either related to embolization with metastasis to the bones 4 and skin or with ischemia in the toes 3 or mesenteric infarction. 9,11 Other symptoms may originate from local aortic occlusion, such as claudication or secondary hypertension in suprarenal tumors.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, the diagnosis is most often made after surgery or autopsy because primary malignancies of the aorta are rare. [1][2][3][4][5][6][7][8][9][10] We describe the preoperative clinical presentation of four patients who proved to have primary malignant tumors of the aorta with different histologic features. On the basis of these cases and the literature, we will characterize common clinical symptoms of primary malignant aortic tumors.…”

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confidence: 99%

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Primary malignant tumors of the aorta: clinical presentation, treatment, and course of different entities

Böhner¹,

Luther²,

Braunstein³

et al. 2003

Journal of Vascular Surgery

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“…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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Massive osteolytic bone metastases from a primary aortic sarcoma: A case report

Cited by 15 publications

References 2 publications

Primary intimal type leiomyosarcoma with rhabdomyosarcomatous differentiation of the thoracic aorta

Primary intimal type leiomyosarcoma with rhabdomyosarcomatous differentiation of the thoracic aorta

Primary malignant tumors of the aorta: clinical presentation, treatment, and course of different entities

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

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