Case Series: Natural History and Treatment of Thoracic Aortic Sarcoma.

Aortic sarcoma is a rare and aggressive malignancy with a poor prognosis despite surgical resection and vascular reconstruction. We present a case series of patients with thoracic aortic sarcoma, highlighting three distinct clinical scenarios: primary resection, resection following prior thoracic aortic endograft, and nonoperative management. Our findings underscore key aspects of aortic sarcoma management, including its embolic potential, diagnostic challenges, and surgical considerations, particularly when endograft explant is required. Despite limited survival, we advocate for complete resection and vascular reconstruction with adjunctive chemoradiotherapy when feasible. Multidisciplinary collaboration remains paramount to optimize postoperative outcome in this complex pathology.