Dissecting Aneurysm of Distal Aortic Arch Caused by an Intimal Angiosarcoma

Abstract

Primary malignant tumor of the aorta is extremely rare. We report herein a case of intimal angiosarcoma of the distal aortic arch. A 38-year-old man with hoarseness, was referred for impending aneurysm of the distal aortic arch. At emergency surgery, a horizontal intimal tear was recognized and the aortic wall was dissected. Prosthetic replacement was employed during partial bypass. The postoperative course was uneventful. Three months after the surgery, routine computed tomography revealed tumor-like lesions in multiple organs. Needle biopsy of the kidney was carried out and metastatic malignant tumor was diagnosed. Although the patient underwent chemotherapy, he died of multiple organ failure due to systemic metastases. On autopsy examination, the final diagnosis was intimal type of angiosarcoma originating from the distal aortic arch with multiple metastases.