St. Mary's Hospital, Imperial College Healthcare NHS Trust, London W2 1NY, UK.
Cardiovasc Intervent Radiol. 2011 Feb;34 Suppl 2:S20-4. doi: 10.1007/s00270-009-9776-3. Epub 2010 Feb 10.
Primary malignant tumours of the aorta are rare. They present with aneurysm formation, arterial occlusion, and embolic phenomenon. We report the case of a 56-year-old man whose initial presentation and investigations lead to emergency endovascular stenting of a descending thoracic aneurysm with a contained leak. Initial response was favourable, yet the patient presented again with worsening symptoms. The circum-aortic haematoma expanded by 50% on subsequent imaging, but no endoleak was identified. When altered bone marrow signal was identified on magnetic resonance imaging, the possibility of malignancy was considered. A metastatic skin lesion was then biopsied, which demonstrated morphological and immunohistochemical features consistent with metastases from a pleomorphic sarcoma of the aorta.
主动脉原发性恶性肿瘤较为罕见。其临床表现为动脉瘤形成、动脉阻塞和栓塞现象。我们报告了一例 56 岁男性患者的病例，其最初的表现和检查导致进行紧急胸降主动脉瘤腔内支架置入术，伴包裹性渗漏。初始反应良好，但患者再次出现症状恶化。随后的影像学检查显示，环绕主动脉的血肿扩大了 50%，但未发现内漏。当磁共振成像显示骨髓信号改变时，考虑到恶性肿瘤的可能性。随后对转移性皮肤病变进行了活检，其形态学和免疫组化特征与主动脉多形性肉瘤的转移灶一致。
