出血性动脉瘤膜下血管肉瘤
Angiosarcoma Beneath a Bleeding Aneurysmal Veil.
作者信息
Fereydooni Arash, George Elizabeth L, Pedroza Albert J, Miller D Craig, Liang David H, Stern Jordan R
机构信息
Division of Vascular and Endovascular Surgery, Department of Surgery, Stanford University, Stanford, California, USA.
Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California, USA.
出版信息
JACC Case Rep. 2025 Jun 4;30(13):103548. doi: 10.1016/j.jaccas.2025.103548.
BACKGROUND
Angiosarcoma is a rare and aggressive vascular tumor that often presents diagnostic and therapeutic challenges. Its potential for misdiagnosis emphasizes the importance of a multidisciplinary approach.
CASE SUMMARY
A 54-year-old man with Loeys-Dietz syndrome and a history of popliteal artery aneurysm treated with surgical exclusion and autologous vein bypass presented with a recurrent hemorrhage from the popliteal fossa. Despite repeated surgical resection and embolization, persistent bleeding led to diffuse alveolar hemorrhage and respiratory failure. Autopsy confirmed metastatic angiosarcoma with bilateral lung involvement.
DISCUSSION
Angiosarcoma is often misdiagnosed due to nonspecific symptoms and overlapping features with benign vascular conditions. This report highlights the rarity, aggressive nature, metastatic potential, and clinically intricate management of popliteal angiosarcoma.
TAKE-HOME MESSAGE: This case underscores the importance of considering angiosarcoma in unusual cases of aneurysmal hemorrhage and the need for comprehensive pathology and a multidisciplinary approach for early detection and treatment.
背景
血管肉瘤是一种罕见且侵袭性强的血管肿瘤，常常带来诊断和治疗方面的挑战。其误诊的可能性凸显了多学科方法的重要性。
病例摘要
一名54岁患有洛伊斯-迪茨综合征且有腘动脉瘤病史的男性，曾接受手术排除和自体静脉搭桥治疗，现腘窝出现反复出血。尽管多次进行手术切除和栓塞治疗，但持续出血导致弥漫性肺泡出血和呼吸衰竭。尸检证实为转移性血管肉瘤，双侧肺均有累及。
讨论
血管肉瘤常因症状不具特异性以及与良性血管疾病特征重叠而被误诊。本报告强调了腘窝血管肉瘤的罕见性、侵袭性、转移潜能以及临床上复杂的管理。
经验教训
该病例强调了在动脉瘤性出血的不寻常病例中考虑血管肉瘤的重要性，以及采用全面病理学检查和多学科方法进行早期检测和治疗的必要性。
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