De Caridi Giovanni, Butrico Lucia, Grande Raffaele, Massara Mafalda, Spinelli Francesco, de Franciscis Stefano, Serra Raffaele
Cardiovascular and Thoracic Department, "Policlinico G. Martino" Hospital, University of Messina, Messina, Italy.
Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
Ann Vasc Surg. 2014 Nov;28(8):1931.e13-6. doi: 10.1016/j.avsg.2014.06.068. Epub 2014 Jul 11.
Takayasu arteritis is a form of large vessel granulomatous vasculitis affecting often young or middle-aged women, especially of Asian descent. It mainly affects the aorta and its branches. Primary malignancies, such as leiomyosarcoma of the aorta are extremely rare. This report discusses the exceptional and concomitant association of Takayasu arteritis and aortic leiomyosarcoma in a 55-year-old male. The patient suffered from systemic signs and symptoms related to arteritis together with claudication of left upper limb due to left artery subclavian stenosis. After instrumental evaluation, an infiltrating neoplasm at the level of abdominal aortic wall was detected and the patient underwent en bloc excision of the mass together with abdominal aorta and subsequent aortoaortic by pass reconstruction. Histologic findings showed an arterial leiomyosarcoma combined with elements of arterial inflammation. Patients completed therapeutic scheme with chemotherapy (doxorubicin and isosfamide) and radiotherapy for the cancer condition, as well as medical treatment (prednisone and adalimumab) for Takayasu arteritis. After 12 months, the patient showed no cancer recurrence and complete normalization of inflammatory indexes and symptoms of Takayasu arteritis.
高安动脉炎是一种大血管肉芽肿性血管炎，常影响年轻或中年女性，尤其是亚洲血统者。它主要累及主动脉及其分支。原发性恶性肿瘤，如主动脉平滑肌肉瘤极为罕见。本报告讨论了一名55岁男性患者中高安动脉炎与主动脉平滑肌肉瘤的罕见并发情况。该患者出现了与动脉炎相关的全身症状，以及因左锁骨下动脉狭窄导致的左上肢间歇性跛行。经过器械评估，在腹主动脉壁水平检测到一个浸润性肿瘤，患者接受了肿块与腹主动脉的整块切除以及随后的主动脉-主动脉旁路重建。组织学检查结果显示为动脉平滑肌肉瘤合并动脉炎症成分。患者完成了针对癌症病情的化疗（阿霉素和异环磷酰胺）和放疗，以及针对高安动脉炎的药物治疗（泼尼松和阿达木单抗）。12个月后，患者未出现癌症复发，高安动脉炎的炎症指标和症状完全恢复正常。
