Malone M D, Kerr K, Kavanah M, Menzoian J O
Department of Surgery, Boston University School of Medicine, MA 02118, USA.
J Vasc Surg. 1996 Sep;24(3):487-93. doi: 10.1016/s0741-5214(96)70207-0.
Primary malignancies of the aorta are extremely rare. A review of the literature indicates that 35 documented cases of primary tumors of the aorta have been reported over the past 120 years. The histologic and morphologic characteristics of these lesions may be variable. In this case, progressive claudication of the left leg and buttocks with absent femoral pulses in a middle-aged woman was found to be a primary leiomyosarcoma of the abdominal aorta. A magnetic resonance imaging study defined a retroperitoneal space-occupying mass on the left side of the aorta at the level of the fourth lumbar vertebrae. A magnetic resonance angiographic scan of the abdominal aorta and an aortogram revealed total occlusion of the distal abdominal aorta with reconstitution at the level of the common femoral arteries bilaterally, with normal vessels more distal to that region. The patient underwent surgical exploration and resection of the retroperitoneal, infrarenal, occluding aortic mass. The mass was found to be a high-grade sarcoma displaying smooth muscle cell differentiation. The resection of this lesion, perioperative management, and pathologic characteristics of a rare primary neoplasm of the aorta are discussed in this review.
主动脉原发性恶性肿瘤极为罕见。文献回顾表明，在过去120年里共报道了35例有记录的主动脉原发性肿瘤病例。这些病变的组织学和形态学特征可能各不相同。在本病例中，一名中年女性出现左腿和臀部进行性跛行且股动脉搏动消失，结果发现是腹主动脉原发性平滑肌肉瘤。磁共振成像研究确定在第四腰椎水平主动脉左侧有一个腹膜后占位性肿块。腹主动脉磁共振血管造影扫描和主动脉造影显示腹主动脉远端完全闭塞，双侧股总动脉水平有血管重建，该区域更远处血管正常。患者接受了手术探查并切除了腹膜后、肾下、闭塞性主动脉肿块。该肿块被发现是一种显示平滑肌细胞分化的高级别肉瘤。本综述讨论了这种罕见的主动脉原发性肿瘤的病变切除、围手术期管理及病理特征。
