Milite Domenico, Pilon Fabio, Ferrari Alessandra, Danieli Daniela, Desole Alessandro
Operative Unit of Vascular and Endovascular Surgery, S. Bortolo Hospital, Vicenza, Italy.
Pathology Department, S. Bortolo Hospital, Vicenza, Italy.
Ann Vasc Surg. 2016 Aug;35:207.e17-21. doi: 10.1016/j.avsg.2016.02.014. Epub 2016 May 27.
We report a case of epithelioid angiosarcoma of the abdominal aortic wall after endovascular treatment for abdominal aortic aneurysm (EVAR). A 60-year-old male, treated 7 years before with EVAR, presented with abdominal back pain, general fatigue, and fever. It was assumed to be a graft infection with periaortic tissue compatible with an inflammatory reaction. The endograft was therefore completely removed and a Dacron silver aorto-bisiliac graft was implanted. After a few days the patient worsened, the angio-computed tomography scan showed a progressive increase of the periaortic mass and numerous small nodules in the abdomen were also detected. The patient was again brought to surgery, an axillo-bifemoral bypass was performed, and the aorto-bisiliac graft was removed but the patient died after surgery. The histological examination showed an aortic epithelioid angiosarcoma with peritoneal metastasis.
我们报告了1例腹主动脉瘤腔内治疗(EVAR)后腹主动脉壁上皮样血管肉瘤的病例。一名60岁男性,7年前接受过EVAR治疗,出现腹部背痛、全身乏力和发热。最初认为是移植物感染伴主动脉周围组织出现符合炎症反应的表现。因此,将腔内移植物完全移除,并植入了带银涂层的涤纶主-双髂动脉移植物。几天后患者病情恶化,血管计算机断层扫描显示主动脉周围肿块逐渐增大,同时在腹部还发现了许多小结节。患者再次接受手术,进行了腋-双股动脉旁路移植术,并移除了主-双髂动脉移植物,但患者术后死亡。组织学检查显示为主动脉上皮样血管肉瘤伴腹膜转移。