Cerebral metastasis from angiosarcoma of the aortic wall: case report

Primary or metastatic cerebral angiosarcoma is extremely rare, and only limited cases have been reported. The authors here describe a case of angiosarcoma, which was initially identified and diagnosed by the cerebral metastatic lesion; later examinations suggested that the primary site was the abdominal aorta.

A 53-year-old man, who had suffered an abdominal aortic aneurysm 2 months earlier, experienced a sudden onset of left-sided hemifacial convulsion and dysarthric speech. Computed tomography (CT) showed a hemorrhagic mass lesion with perifocal edema in the right frontal lobe. Magnetic resonance imaging (MRI) showed a regionally marked hypointensity in the mass lesion on both T1- and T2-weighted images, which might suggest hemosiderin deposition. The tumor was removed in its entirety. Pathologic examination revealed an old hematoma with a hemosiderin deposit containing markedly atypical tumor cells, and angiosarcoma was diagnosed. Resection of the abdominal aortic aneurysm and iliac bone biopsy were performed and angiosarcoma was recognized in each surgical specimen. Based on clinical and pathologic findings, the primary site was considered to be the abdominal aorta.

Clinicians should be aware of this rare histologic type of tumor. Unique MRI findings such as those obtained in our case might be useful for differentiating this condition from other intracranial neoplasms.