Nakamura Hiroki, Kanki Akihiko, Watanabe Hiroyuki, Ono Kentarou, Kuwada Noriaki, Saisho Shinsuke, Nishimura Hirotake, Yamamoto Akira, Tamada Tsutomu
Departments of Radiology, Kawasaki Medical School, Kurashiki, Japan.
Department of Cardiovascular Surgery, Kawasaki Medical School, Kurashiki, Japan.
Acta Radiol Open. 2021 Dec 7;10(11):20584601211063360. doi: 10.1177/20584601211063360. eCollection 2021 Nov.
Primary aortic sarcoma is a very rare disease, and most primary aortic tumors are malignant mesenchymal tumors. We present the case of a 62-year-old man with sudden epigastric and back pain. Contrast-enhanced computed tomography (CT) revealed a mass lesion about 33.8 mm in diameter, in contact with the left side of the abdominal aorta. Impending rupture of an abdominal aortic aneurysm was suspected, so cardiovascular surgery for stent graft placement was performed the same day. Symptoms immediately improved and CT at 3 months postoperatively showed a marked decrease in lesion size, but the lesion subsequently grew again. Fluorodeoxyglucose (FDG)-positron emission tomography/CT was performed due to the possibility of malignant solid tumor, revealing markedly increased FDG accumulation (maximum standardized uptake value, 36.95) in the mass lesion. Primary aortic sarcoma was diagnosed from thoracoscopic biopsy. Here, we report a primary aortic sarcoma that shrank due to tumor infarction after stent graft placement, followed by tumor regrowth.
原发性主动脉肉瘤是一种非常罕见的疾病，大多数原发性主动脉肿瘤是恶性间叶性肿瘤。我们报告一例62岁男性，突发上腹部和背部疼痛。增强计算机断层扫描（CT）显示一个直径约33.8毫米的肿块，与腹主动脉左侧相连。怀疑腹主动脉瘤即将破裂，因此于同日进行了心血管手术以置入支架移植物。症状立即改善，术后3个月的CT显示病变大小明显减小，但病变随后再次增大。由于存在恶性实体瘤的可能性，进行了氟脱氧葡萄糖（FDG）-正电子发射断层扫描/CT，显示肿块病变中FDG积聚明显增加（最大标准化摄取值，36.95）。经胸腔镜活检诊断为原发性主动脉肉瘤。在此，我们报告一例原发性主动脉肉瘤，在置入支架移植物后因肿瘤梗死而缩小，随后肿瘤复发。
