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A Case of Upper Limb Arterial Embolization from Aortic Arch Intimal Sarcoma
Yasunori Iida1, Akihiro Yoshitake1, Hideyuki Shimizu1
1Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan.
Annals of Vascular Diseases
|November 8, 2018
Summary
Aortic intimal sarcoma can cause arterial embolization, leading to limb paralysis. Surgical resection and aortic arch replacement were performed, but the patient developed widespread metastasis and died within six months.
Area of Science:
- Cardiovascular Surgery
- Surgical Oncology
- Vascular Medicine
Background:
- Aortic intimal sarcoma is a rare and aggressive malignancy.
- Intimal sarcoma can present with embolic events due to tumor fragility.
- Diagnosis often involves advanced imaging and surgical exploration.
Purpose of the Study:
- To report a rare case of aortic intimal sarcoma presenting with arterial embolization.
- To describe the diagnostic and surgical management of this condition.
- To highlight the aggressive nature and poor prognosis of aortic intimal sarcoma.
Main Methods:
- Transesophageal echocardiogram to visualize the aortic mass.
- Contrast-enhanced computed tomography for tumor characterization and vascular involvement.
- Surgical resection of the aortic tumor with en bloc total arch replacement.
Main Results:
- A mobile, fragile mass in the aortic arch was identified.
- The tumor caused occlusion of the left common carotid and subclavian arteries.
- Postoperative metastasis to the limbs was observed despite successful resection.
- The patient succumbed to the disease six months after surgery.
Conclusions:
- Aortic intimal sarcoma requires prompt diagnosis and aggressive surgical management.
- Embolic events are a significant complication of aortic intimal sarcoma.
- Despite surgical intervention, the prognosis remains poor due to the high propensity for metastasis.
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