Retroperitoneal Liposarcoma Masquerading as an Impending Rupture of Inflammatory Abdominal Aortic Aneurysm

Karkos, Christos D.; Pepis, Panagiotis D.; Theologou, Marios; Ballas, Konstantinos; Petras, Panagiotis; Arapoglou, Stergios; Giagtzidis, Ioakeim T.; Mitka, Maria; Pliatsios, Ioannis; Papazoglou, Konstantinos; Kambaroudis, Apostolos

doi:10.1016/j.avsg.2018.08.103

Cited by 3 publications

(3 citation statements)

References 4 publications

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“…Liposarcomas separated into four histologic subtypes: well differentiated, dedifferentiated, myxoid, and pleomorphic; pleomorphic liposarcoma is the least common malignant adipocytic neoplasm, accounting for approximately 5% of all cases (4). Cases of liposarcoma invading vascular system are seldom, there are just 2 cases reported that retroperitoneal liposarcoma invading abdominal aorta (5,6). Mediastinal pleomorphic liposarcoma invaded the aorta simulating PUA of the descending aorta is an extremely rare occurrence and has not been previously reported in the literature.…”

Section: Discussionmentioning

confidence: 97%

Mediastinal liposarcoma masquerading as penetrating aortic ulcer in the descending aorta: a case report

Wang¹,

Lv²,

Lin³

et al. 2020

Cardiovasc Diagn Ther

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A 56-year-old woman with a history of hypertension and cerebral infarction was admitted to the hospital complaining of progressive and severe chest pain for 1 day. CT scan revealed a descending penetrating ulcer. Accordingly, she underwent an uneventful endovascular repair with a thoracic endograft.One month later the patient presented to our clinic with chest and back pain again. The contrast CT indicated that the periaortic mass grew larger, which interpreted as hematoma resulting from endoleak.But no endoleak was found by angiography. CT-guided needle biopsy was carried out, the histology of the mass revealed a pleomorphic liposarcoma. Liposarcomas are malignant fat-containing tumors derived from mesenchymal cells that typically occur in the extremities and retroperitoneum, mediastinal liposarcoma account for less than 1% in mediastinal malignancies; pleomorphic liposarcoma is the least common liposarcomas. Cases of liposarcoma invading vascular system are seldom, to our knowledge, it is the first case of mediastinal pleomorphic liposarcoma invaded the descending aorta. It is worth mentioning that in the modern endovascular era, the majority of aortic diseases are being repaired by endovascular techniques.When patients with growing periaortic mass post endovascular repair and endograft-related causes have been excluded, the rare possibility of mediastinal liposarcoma should arise as a differential diagnosis. Promptly CT-guided biopsy help establish an early diagnosis.

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Section: Discussionmentioning

confidence: 97%

Mediastinal liposarcoma masquerading as penetrating aortic ulcer in the descending aorta: a case report

Wang¹,

Lv²,

Lin³

et al. 2020

Cardiovasc Diagn Ther

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“…Tumor infiltration is a rare cause of aortic rupture. Besides the germ cell testicular cancer [ 16 ], abdominal aortic invasion has also been reported in other types of malignancies as soft tissue sarcomas [ 17 – 20 ], paragangliomas [ 21 ], lymphomas [ 22 ] and gynecological tumors [ 23 ]. Most authors consent that endovascular aortic intervention is an effective and safe method which should be encouraged to provide a definite therapeutic impact in a subset of patients who would otherwise not be candidates for curative surgery.…”

Section: Discussionmentioning

confidence: 99%

Successful emergency endovascular aortic repair for intratumoral hemorrhage in extensive retroperitoneal mass of testicular origin

Huľová

Aziri

Vulev³

et al. 2020

BMC Surg

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Background Metastatic germ cell cancer of the testis is characterized by favorable prognosis since effective treatment methods are available even in cases of extensive disease. Retroperitoneal masses frequently encroach major blood vessels requiring a vascular intervention usually performed in association with the post-chemotherapy retroperitoneal lymph node dissection (RPLND). Reported clinical case describes a successful pre-treatment endovascular surgery for abdominal aortic rupture allowing for full-dose systemic chemotherapy administration, and subsequent radical surgical intervention at primary tumor site as well as metastatic retroperitoneal lymph node dissection including the reconstruction of inferior caval vein. Case presentation Patient presented with left-sided testicular tumor and voluminous retroperitoneal mass with vascular involvement. Soon after the patient had been admitted for the first cycle of cisplatin-based chemotherapy, computed tomographic angiography (CTA) revealed a dorsal aortic wall rupture with active extravasation and irregular pseudoaneurysmatic dilatation of the aorta below the leak area. Retroperitoneal intratumoral hemorrhage associated with the bilateral iliac venous thrombosis required an endovascular repair procedure of infrarenal abdominal aorta. Conclusions Following the successful endovascular aortic repair 3 cycles of BEP (bleomycin, etoposide, cisplatin) regimen were administered with subsequent delayed left radical orchiectomy and RPLND associated with vena cava inferior (VCI) resection. Reconstruction of VCI was originally not deemed necessary as collateral blood flow appeared sufficient, however, intraoperative complications resulted in the need for unilateral VCI reconstruction, using the interposed bypass between right common iliac vein and infrarenal segment of VCI. Histopathologic examination of the attained specimen detected no vital cancer structures. The patient remains disease-free 18 months after the RPLND.

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“…Beside lymphoma there are other malignancies that can uncommonly originate in retroperitoneal space, Milite et al described a fatal case of a retroperitoneal angiosarcoma surrounding AAA in a patient 7 years after successful EVAR, which was also primarily thought of as infectious complication [17]. Other cases deal with ruptured AAA after EVAR, as a first sign of retroperitoneal angioinvasive liposarcoma [18], and liposarcoma causing an impending rupture of inflammatory AAA, in a patient, who afterwards underwent urgent EVAR [19].…”

Section: Discussionmentioning

confidence: 99%

Emergence of a lymphoma imitating an infectious infiltration surrounding the infrarenal aorta after EVAR

Vajda¹,

Raupach

Krajina

et al. 2019

Vasa

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Retroperitoneal Liposarcoma Masquerading as an Impending Rupture of Inflammatory Abdominal Aortic Aneurysm

Cited by 3 publications

References 4 publications

Mediastinal liposarcoma masquerading as penetrating aortic ulcer in the descending aorta: a case report

Mediastinal liposarcoma masquerading as penetrating aortic ulcer in the descending aorta: a case report

Successful emergency endovascular aortic repair for intratumoral hemorrhage in extensive retroperitoneal mass of testicular origin

Emergence of a lymphoma imitating an infectious infiltration surrounding the infrarenal aorta after EVAR

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