de Jorge-Huerta Lucía, Sayed El Shershaby Shehab, Escudero Arellano Claudia, Castilla Salar Rubén
Department of Internal Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain
Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain.
BMJ Case Rep. 2025 Jun 22;18(6):e264423. doi: 10.1136/bcr-2024-264423.
Primary aortic tumours are extremely rare, with fewer than 250 cases reported in the literature. We present the case of an octogenarian man with an incidental aortic mass detected on CT, initially misdiagnosed as a thrombus. Its atypical radiological features-large size in a high-flow area without an associated aneurysm-and persistence despite anticoagulation raised suspicion of an aortic tumour. However, imaging studies (positron emission tomography-CT and magnetic resonance angiography) were inconclusive. A definitive diagnosis of primary aortic sarcoma was made postmortem through histological examination of an embolic fragment obtained during emergency surgery for acute lower-limb arterial ischaemia, a fatal complication that ultimately led to the patient's death. This case emphasises the importance of maintaining a high index of clinical suspicion for aortic tumours and highlights the critical need for further evidence and case reports to improve the multidisciplinary management of this exceptionally rare and highly fatal condition.
原发性主动脉肿瘤极为罕见，文献报道的病例不足250例。我们报告了一例八旬男性患者，其在CT检查时偶然发现主动脉肿块，最初被误诊为血栓。其不典型的放射学特征——位于高血流区域的大尺寸肿块且无相关动脉瘤——以及尽管进行了抗凝治疗但肿块持续存在，引发了对主动脉肿瘤的怀疑。然而，影像学检查（正电子发射断层扫描-CT和磁共振血管造影）结果不明确。通过对急诊手术治疗急性下肢动脉缺血期间获取的栓塞碎片进行组织学检查，在尸检时确诊为原发性主动脉肉瘤，急性下肢动脉缺血是一种致命并发症，最终导致患者死亡。该病例强调了对主动脉肿瘤保持高度临床怀疑的重要性，并突出了迫切需要更多证据和病例报告以改善这种极其罕见且高度致命疾病的多学科管理。
