Aortic intimal sarcoma with embolic metastases

Aortic tumours: report of a case and review of the literature

We present a case of a leiomyosarcoma originating in the wall of the descending aorta and give a review of 27 previously reported cases of aortic neoplasms. An extraluminal aortic leiomyosarcoma has not been reported before in the literature.

Immunohistochemical and ultrastructural studies of a primary aortic intimal sarcoma

An intimal sarcoma of the abdominal aorta in a 63-year-old woman is reported. The clinical symptoms consisted of chronic arterial hypertension, vomiting and epigastric pain. Treatment was operative, but the patient died 20 hours after surgery. The studies were performed on a surgical specimen and on autopsy material. The aortic tumour consisted of pleomorphic spindle-shaped and giant cells. In the vertebral metastases a storiform pattern of the tumour cells was found. No specific features characteristic for leiomyogenic, lipogenic or an endothelial nature of the tumour giant cells was disclosed in electron microscopy and the picture rather indicated their histiocytic character. Of the 18 cellular markers studied, the immunostainings for vimentin and alpha-1-antichymotrypsin were evidently positive. The tumour was classified as a pleomorphic intimal aortic sarcoma probably a malignant fibrous histiocytoma (MFH). The literature on 26 previously published aortal tumours is reviewed with emphasis on their topographical distribution and histological classification. In only 4 previous cases was the final diagnosis supported by electron microscopical or immunopathological findings. The role of marker studies in the classification of aortal tumours is discussed.

Spindle cell sarcoma of the heart in childhood: light microscopic, ultrastructural, and immunohistochemical evidence for smooth muscle, endothelial, and fibroblastic differentiation

We describe the clinical presentation and pathological features of a cardiac sarcoma that occurred within the right atrial cavity of a 14-year-old boy. The patient presented with a 2-month history of increasingly severe heart failure. Tumor tissue obtained by biopsy showed light microscopic features of leiomyosarcoma. Immunohistochemical reactions and ultrastructural studies provided evidence of tumor cell differentiation along three cell lines--smooth muscle, fibroblastic, and endothelial--suggestive of origin from a multipotent subendothelial reserve cell. Postmortem examination disclosed a large necrotic tumor filling the right atrial chamber. Implants were present on the pericardium, but there were no other metastatic lesions. The difficulty of making a diagnosis of these rare neoplasms when the tumor is small and potentially curable results in a grim prognosis.