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Aortic Pleomorphic Sarcoma Presenting With Claudication: A Rare Diagnostic Challenge.
Zehra Ünlü1, Sedat Karaca1, Aysen Yaprak Kapkin1
1Department of Cardiovascular Surgery, Ege University School of Medicine, Izmir, Turkey.
Vascular and Endovascular Surgery
|October 9, 2025
Summary
Aortic pleomorphic sarcomas, rare vascular tumors, can mimic ischemic symptoms, delaying diagnosis. Early detection via imaging and pathology is crucial for treatment, despite a poor prognosis.
Area of Science:
- Vascular Surgery
- Surgical Oncology
- Diagnostic Imaging
Background:
- Aortic pleomorphic sarcomas are rare, aggressive vascular tumors.
- These tumors often present with nonspecific symptoms, leading to diagnostic delays.
Purpose of the Study:
- To report a case of aortic pleomorphic sarcoma presenting as isolated lower extremity claudication.
- To emphasize the diagnostic challenges and importance of early recognition.
Main Methods:
- Case report of a 53-year-old male with isolated lower extremity claudication.
- Diagnostic workup included physical examination, duplex vascular ultrasound, CT angiography, and histopathological analysis.
- Treatment involved surgical repair and subsequent chemotherapy.
Main Results:
- CT angiography revealed an abdominal aortic aneurysm with iliac artery stenosis.
- Histopathology confirmed undifferentiated pleomorphic sarcoma with a high Ki67 index.
- Postoperative PET-CT showed metastatic disease to the lungs, liver, and bones.
Conclusions:
- Undifferentiated pleomorphic sarcoma can present insidiously with ischemic symptoms, complicating diagnosis.
- Prompt imaging and histopathological evaluation are vital for timely diagnosis and management.
- Surgical resection is the primary treatment, though prognosis remains guarded due to aggressive nature and metastatic potential.
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