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Aortitis as a Harbinger of Occult Malignancy
Erik W O'Connell1, Jennifer Reams1, Alfred E Denio1
1Division of Rheumatology MC 2152, Geisinger Medical Center, 100 N Academy Ave., Danville, PA 17822, USA.
Case Reports in Rheumatology
|April 3, 2019
Summary
Noninfectious aortitis can be linked to hidden cancer. Treating the malignancy effectively reduced aortic inflammation and symptoms, highlighting the importance of identifying underlying causes.
Area of Science:
- Cardiovascular Medicine
- Oncology
- Pathology
Background:
- Noninfectious aortitis lacks clear evidence-based treatment guidelines, with glucocorticosteroids often used empirically.
- Identifying and treating the underlying cause is crucial for effective management of aortitis.
- Vasculitis, particularly large vessel vasculitis, can be a paraneoplastic syndrome.
Observation:
- A case initially suspected as bacterial endocarditis revealed aseptic ischemic valvitis and concurrent aortitis on pathology and angiography.
- Diagnostic imaging identified an occult colon adenocarcinoma as the underlying cause.
- The patient presented with symptoms related to inflammation affecting the entire aorta.
Findings:
- Treatment of the underlying colon adenocarcinoma led to significant mitigation of aortic inflammation.
- A reduction in aortitis-associated symptoms was observed following malignancy treatment.
- This case illustrates a paraneoplastic vasculitis secondary to colon cancer.
Implications:
- This case underscores the importance of considering malignancy in patients with noninfectious aortitis, especially when other causes are excluded.
- Early diagnosis and treatment of occult malignancies can dramatically impact the morbidity and mortality associated with paraneoplastic aortitis.
- Further research into the mechanisms and optimal management of paraneoplastic vasculitis is warranted.
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