# Suspected Symptomatic Infected Native Aortic Aneurysm Turns Out To Be Aortic Tumour Originating From Metastatic Cancer of Unknown Primary: A Case Report and Review of Literature

## TL;DR

A patient suspected of having an infected aortic aneurysm was found to have a metastatic cancer of unknown origin, highlighting diagnostic challenges and the importance of surgical biopsy.

## Contribution

This case report highlights the diagnostic difficulty of primary aortic tumors and advocates for surgical intervention to obtain a definitive diagnosis.

## Key findings

- Aortic tumors can mimic infected aneurysms, leading to diagnostic delays.
- Surgical biopsy is crucial for accurate diagnosis in suspected aortic tumors.
- Multidisciplinary treatment may improve outcomes in metastatic aortic cancer.

## Abstract

The non-specific clinical presentation of a primary aortic tumour may mimic infectious processes. Together with its rarity, this resemblance can complicate timely identification and pose diagnostic challenges.

The case of a 77 year old male patient complaining of abdominal pain radiating to the back, fatigue, and loss of appetite for a month, is presented. Contrast enhanced computed tomography showed a 47 mm infrarenal aortic aneurysm with peripheral enhancement. With suspicion of an infected native aortic aneurysm, open aortic repair was performed using a bovine pericardial Y prosthesis. The intra-operative biopsy revealed a malignant undifferentiated neoplasm, which later turned out to originate from metastatic cancer of unknown primary. The patient died six months later following comprehensive and extensive oncological treatment, which included radiotherapy and chemotherapy.

Given the scarcity of literature and challenges in classification, treatment recommendations rely on a multidisciplinary approach, involving surgery, radiotherapy, and chemotherapy. Despite the lack of established guidelines, early intervention, even in metastatic cases, may improve clinical outcomes. Surgical resection, whenever appropriate, is advocated, as it not only alleviates symptoms, but intra-operative histological sampling also aids in obtaining a definitive diagnosis.