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Incidental floating aortic mass as the initial presentation of primary aortic sarcoma
Lucía de Jorge-Huerta1, Shehab Sayed El Shershaby2, Claudia Escudero Arellano3
1Department of Internal Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain luciajorgehuerta@hotmail.com.
BMJ Case Reports
|June 22, 2025
Summary
Primary aortic tumors are rare, often misdiagnosed. This case highlights the challenge in diagnosing aortic sarcoma, emphasizing the need for high clinical suspicion and further research for better patient management.
Area of Science:
- Vascular Surgery
- Oncology
- Radiology
Background:
- Primary aortic tumors are exceptionally rare, with fewer than 250 reported cases.
- Aortic masses are often misdiagnosed as thrombi, complicating diagnosis and management.
Purpose of the Study:
- To report a case of primary aortic sarcoma in an octogenarian.
- To highlight diagnostic challenges and the importance of clinical suspicion for rare aortic tumors.
Main Methods:
- Computed tomography (CT) scan for initial detection.
- Positron emission tomography-CT (PET-CT) and magnetic resonance angiography (MRA) for further imaging.
- Postmortem histological examination of an embolic fragment for definitive diagnosis.
Main Results:
- An incidental aortic mass was detected on CT, initially presumed to be a thrombus.
- Atypical radiological features and persistence despite anticoagulation suggested a tumor.
- Definitive diagnosis of primary aortic sarcoma was made postmortem after a fatal complication of acute lower-limb arterial ischemia.
Conclusions:
- Primary aortic tumors, such as sarcoma, require a high index of clinical suspicion due to their rarity and potential for misdiagnosis.
- Improved diagnostic strategies and multidisciplinary management are crucial for this rare and fatal condition.
- Further case reports and evidence are needed to enhance understanding and treatment approaches.
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