Intimal sarcoma in an inflammatory aneurysm after endovascular aneurysm repair

Abstract

Long-term outcomes after endovascular aneurysm repair (EVAR) for inflammatory aneurysms are unknown. We present a young patient with new-onset back pain and failure to thrive 6 years after EVAR for an inflammatory abdominal aortic aneurysm (AAA). Endograft explanation was performed with a presumed diagnosis of infection. Pathology revealed intimal sarcoma in the excluded aneurysm sac with liver metastasis. This report presents a detailed review of literature regarding potential association of prosthetic implantation and carcinogenesis.

Intimal sarcomas of the aorta and iliofemoral arteries: a clinicopathological study of 26 cases

“…[1][2][3] The classification of intimal sarcomas is controversial. Arterial sarcomas are typically intraluminal, and are most frequent in the aorta, pulmonary arteries, and proximal arteries of the lower extremities.…”

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

“…In this regard, an important consideration is the duration between repair and the diagnosis of aortic sarcoma. For the few cases previously reported in the literature, the aortic sarcomas were diagnosed 5-7 years after endograft repair [3,14,15]. In our case series, the post-repair periods leading to aortic sarcoma diagnosis were 8-years and 6-months for cases 1 and 3 (this information was not available for case 2), respectively.…”

Detection of a primary tumor in the area of the renal artery with 18F-FDG PET/CT in a patient with metastatic undifferentiated sarcoma and a history of mid-aortic syndrome

“…[1] Intimal sarcomas have been reported to arise in association with vascular prostheses suggesting a tumor inducing effect of foreign material on the endothelium. [2,3] In this case report the development of an intimal sarcoma in a multiple stented renal artery due to mid-aortic syndrome is presented. To our knowledge, no case from intimal sarcoma in the area of the renal artery with a history of stenting has been described using 18 F-FDG PET/CT.…”

“…[1] The association between intimal sarcoma development and chronic foreign body reaction due to vascular prosthesis has been described. [2,3] Fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) is an imaging modality with high negative predictive value and specificity in detecting adult soft tissue sarcoma. [4] However, few reports have indicated the capacity of 18 F-FDG PET/CT to detect intimal sarcoma in different sites.…”