Aortic intimal sarcoma masquerading as bilateral renal artery stenosis

Area of Science:

• Vascular Surgery
• Oncology
• Nephrology

Background:

• Aortic intimal sarcoma is an exceptionally rare malignant tumor originating from the aortic intima.
• It typically presents with thromboembolic events or vascular obstruction, often with a grim prognosis.
• Early diagnosis and effective management strategies remain significant challenges in clinical practice.

Observation:

• This case highlights an unusual presentation of aortic intimal sarcoma.
• The tumor induced bilateral renal artery stenosis, resulting in refractory hypertension and acute kidney injury.
• The patient experienced unsuccessful attempts at renal artery stenting.

Findings:

• Aortic intimal sarcoma can manifest as severe renal artery stenosis, complicating hypertension and kidney function.
• The tumor's obstructive nature led to critical limb ischemia and oliguric kidney failure.
• The intricate vascular involvement underscores the tumor's aggressive pathology.

Implications:

• This case emphasizes the need for heightened clinical suspicion for rare tumors in patients with unexplained vascular complications.
• It suggests that standard interventions like stenting may be ineffective for tumor-induced stenosis.
• Further research into novel therapeutic approaches for aortic intimal sarcoma is warranted to improve patient outcomes.