Case Reports Journal Article Epublish
PubMed: 42952852 DOI: 10.3389/fsurg.2026.1972877
Abdominal aortic angiosarcoma following endovascular aneurysm repair: case report and analysis of existing literature.
Front Surg 13:1972877
Authors: Loes H Willems, Marcus Steinbach, Daniel Pink, Thomas Herold, Alexander Meyer, Roger Wahba
Affiliations
- Clinic of Vascular Surgery, Helios Klinikum Berlin-Buch, Berlin, Germany.
- Clinic of General, Visceral and Oncological Surgery, Helios Klinikum Berlin-Buch, Berlin, Germany.
- Department of Oncology and Palliative Care, Helios Klinikum Berlin-Buch, Berlin, Germany.
- Department of Internal Medicine, University Hospital Greifswald, Greifswald, Germany.
- Clinic of Diagnostic and Interventional Radiology, Helios Klinikum Berlin-Buch, Berlin, Germany.
- Clinic of Vascular Surgery, Helios Klinikum Berlin-Buch, Berlin, Germany. Medical School Berlin, Berlin, Germany.
Abstract
Abdominal aortic angiosarcoma following endovascular aneurysm repair (EVAR) is an exceptionally rare and aggressive malignancy that may mimic common EVAR-related complications. We report the case of a 72-year-old man who presented with progressive lower back pain and was initially suspected of having a graft infection. Imaging revealed a periaortic mass involving a previously treated abdominal aortic aneurysm. Biopsy confirmed aortic angiosarcoma. No regional lymph node or distant metastases were identified. The patient underwent neoadjuvant chemotherapy with gemcitabine and docetaxel, followed by radiotherapy and surgical resection of the abdominal aorta and EVAR graft with aortic reconstruction. Histopathological examination demonstrated complete pathological response without evidence of residual angiosarcoma. Our literature review identified only 21 reported cases of abdominal aortic angiosarcoma following EVAR, including the present case, underscoring the exceptional rarity of this entity and the limited evidence available to guide diagnosis and treatment. This case highlights the importance of considering aortic angiosarcoma in patients with persistent symptoms and atypical periaortic findings after EVAR and suggests that early biopsy and a multidisciplinary, multimodal treatment approach may improve outcomes despite the generally poor prognosis associated with this disease.
MeSH
Hemangiosarcoma, Aneurysm, Transplants, Therapeutics, Aortic Aneurysm, Abdominal, Endovascular Aneurysm Repair