Epithelioid Angiosarcoma With Metastatic Disease After Endovascular Therapy of Abdominal Aortic Aneurysm

Abstract

Malignancies of the aortic wall represent a rare condition, and only a few reports have covered cases of sarcomas arising at the site of a prosthesis made of Dacron. A coincidence with endovascular repair has only been reported in one case to date. We report a patient with epithelioid angiosarcoma and metastatic disease, which was found in an aneurysmal sac after endovascular aortic repair for abdominal aortic aneurysm.

Challenges in diagnosing aortic leiomyosarcoma post endovascular repair of abdominal aortic aneurysm

“…With respect to aortic endografts, some investigators have suggested an association between endograft infection and subsequent malignancy, although this remains speculative. 13,[17][18][19][20] While causality cannot be proven, other authors, like in our case, testify that malignancy was not seen at the time of surgical graft implantation and was not seen on pre-operative imaging at the time of endograft implantation. Furthermore, as in this case, the malignancy arises in the aortic wall adjacent to the graft.…”

Multimodality Imaging Approach towards Primary Aortic Sarcomas Arising after Endovascular Abdominal Aortic Aneurysm Repair: Case Series Report

“…Histologically, the aortic sarcomas represent a heterogeneous group with major reported subtypes including angiosarcoma, leiomyosarcoma, fibrosarcoma, fibromyxosarcoma, fibroxanthosarcoma, and malignant fibrous histiocytoma [4]. Primary aortic angiosarcoma (2 of the 3 cases reported here; previously &35 reported cases) and primary aortic sarcoma arising after EVAR (all 3-cases in this report; previously 2 reported cases) are unique subsets of this pathology [2,3]. To our knowledge, the presented cases series is the largest describing primary aortic sarcomas in the setting of successful endovascular repair.…”

“…Since their first description in surgical literature by Brodowski in 1873, only approximately, 140 cases have been reported [1]. A unique subset of this rare pathology is aortic sarcomas arising after endovascular aneurysm repair (EVAR), reports of which are scarce in the published literature [2,3]. As the presenting symptoms can be non-specific and may be mistakenly attributed to more common aortic disease processes, the diagnosis of an underlying aortic malignancy can be challenging and often delayed.…”

Uterine Epithelioid Angiosarcoma on F-18 FDG PET/CT

“…[4] F-18 FDG PET/CT experiences in imaging angiosarcoma at anterior mediastinum, vessel, epicardium and adrenal gland were reported. [14][15][16][17] These reports have described variable F-18 FDG avidity of epithelioid angiosarcoma, which were mild to intense in F-18 FDG uptake (SUVmax up to 9.7). To our knowledge, the F-18 FDG PET/CT findings of primary uterine angiosarcoma have not been previously reported.…”