Pleomorphic undifferentiated aortic sarcoma presenting as persistent endoleak after endovascular aneurysm repair

Sarcomas of the aorta are rare tumors with an unknown incidence and wide variety of clinical presentations. These malignant neoplasms are often manifested in an advanced state and with symptoms of nonmalignant vascular disease owing to a delay in diagnosis. We present the case of a 78-year-old man in whom workup was initially performed for a persistently enlarging abdominal aortic aneurysm after endovascular aortic repair but who was subsequently found to have a pleomorphic undifferentiated sarcoma of the aorta.