Aortic intimal sarcoma mimicking a mycotic pararenal abdominal aortic aneurysm

TL;DR

A rare case of aortic intimal sarcoma was mistaken for a mycotic aneurysm, leading to surgery and eventual death from metastasis.

Contribution

Highlights the diagnostic challenge of aortic intimal sarcoma mimicking infectious aneurysms.

Findings

Aortic intimal sarcoma was misdiagnosed as a mycotic aneurysm based on imaging and clinical presentation.

The patient underwent hybrid surgery but was later found to have sarcoma confirmed by pathology.

The patient died two years later from sepsis and bone metastases following chemotherapy.

Abstract

We present a case of aortic intimal sarcoma mimicking a mycotic para-renal abdominal aortic aneurysm, treated with staged hybrid surgery. A 60-year-old female presented with complaints of nausea and back pain. Computed tomography showed a para-renal abdominal aortic aneurysm with irregular and multilobulated shape, without periaortic soft-tissue inflammation, occlusion of the celiac artery, and stenosis of the superior mesenteric artery. She underwent superior mesenteric artery stenting, followed by aortic resection and axillo-femoral bypass for suspicion of mycotic aortic aneurysm. Pathologic examination revealed aortic intimal sarcoma. Two years after surgery, she died of multiple organ failure due to sepsis during chemotherapy for bone metastases.

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