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Aortic intimal sarcoma with embolic metastases.

E P Wright, A D Glick, R Virmani

    The American Journal of Surgical Pathology
    |December 1, 1985
    PubMed
    Summary
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    A rare aortic sarcoma caused fatal bowel infarction in a patient. This study proposes a new classification for these myofibroblastic tumors based on location and morphology.

    Area of Science:

    • Vascular pathology
    • Oncology
    • Surgical pathology

    Background:

    • Primary aortic intimal sarcomas are rare neoplasms with varied histologic diagnoses.
    • Understanding their origin and behavior is crucial for accurate diagnosis and treatment.

    Observation:

    • A 46-year-old woman presented with massive bowel infarction due to a primary sarcoma on the aortic intimal surface.
    • Tumor emboli were found in aortic branches and abdominal organs.
    • Electron microscopy revealed myofibroblastic differentiation, excluding endothelial origin.

    Findings:

    • Histologic terms for these tumors are inconsistent, hindering comparisons.
    • Clinical presentation correlates with lesion location and gross morphology.
    • A proposed clinicopathologic classification categorizes lesions as intimal (obstructive/nonobstructive) or mural.

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    Implications:

    • The proposed classification aids in comparing rare aortic intimal sarcomas.
    • Intimal sarcomas are likely of myofibroblastic origin.
    • Mural sarcomas are typically leiomyosarcomas or fibrosarcomas originating from the aortic wall.