Ciaramella Piera, Anticoli Sabrina, Crupi Domenica, Pergolini Amedeo, Russo Marco, Macciomei Maria Cristina, Veccia Norman, Lio Antonio, Ranocchi Federico
Department of Cardiac Surgery and Heart Transplantation, San Camillo Forlanini Hospital, Rome, Italy; Department of Cardiology, La Sapienza University of Rome, Umberto I Hospital, Rome, Italy.
Department of Head, Neck and Neuroscience, San Camillo Forlanini Hospital, Rome, Italy.
JACC Case Rep. 2025 May 21;30(11):103329. doi: 10.1016/j.jaccas.2025.103329. Epub 2025 Apr 9.
Primary malignant tumors of the aorta represent a group of sarcomas arising from the aortic wall. Onset typically occurs in the fifth and sixth decades of life, and the prognosis is poor. Herein, we present the case of a 33-year-old patient with an acute neurological syndrome of uncertain origin. She underwent thrombolysis and mechanical thrombectomy of the left M1 cerebral artery and was discharged home with antiplatelet and anticoagulation therapy. After 30 days, follow-up imaging showed thrombotic-like formations in the ascending aorta, so she underwent urgent cardiac surgery. The histological and immunohistochemical studies showed an unexpected diagnosis of intimal sarcoma. A multidisciplinary approach was mandatory to define the timing of diagnosis and treatment.
主动脉原发性恶性肿瘤是一组起源于主动脉壁的肉瘤。发病通常发生在50至60岁之间，预后较差。在此，我们报告一例33岁病因不明的急性神经综合征患者。她接受了左侧大脑中动脉M1段的溶栓和机械取栓治疗，并在接受抗血小板和抗凝治疗后出院回家。30天后，随访影像显示升主动脉有血栓样形成，因此她接受了紧急心脏手术。组织学和免疫组化研究显示意外诊断为内膜肉瘤。必须采用多学科方法来确定诊断和治疗的时机。
