Investig Magn Reson Imaging.  2019 Jun;23(2):162-166. 10.13104/imri.2019.23.2.162.

Undifferentiated Pleomorphic Sarcoma of the Descending Thoracic Aorta Mimicking Pseudoaneurysm with Periaortic Hematoma: a Case Report

• Kim M
• Bae YA
• Byeon SJ
• Choi JA

• KMID: 2452531
• DOI: http://doi.org/10.13104/imri.2019.23.2.162

Abstract

Undifferentiated pleomorphic sarcoma (UPS) arising from the descending thoracic aorta is a rare type of tumor. To our knowledge, only a few cases have been reported in the literature. We present computed tomography (CT) and magnetic resonance imaging findings of a 43-year-old male patient with undifferentiated pleomorphic sarcoma of the descending thoracic aorta, which showed enhancement on only magnetic resonance imaging (MRI). MRI with contrast enhancement may be useful in differentiating an aortic tumor from atherosclerotic disease.

Keyword

Sarcoma; Thoracic aorta; Computed tomography; Magnetic resonance imaging

MeSH Terms

Adult
Aneurysm, False*
Aorta, Thoracic*
Hematoma*
Humans
Magnetic Resonance Imaging
Male
Sarcoma*

Figure

• 

  Fig. 1 Chest CT images of a 43-year-old man with undifferentiated pleomorphic sarcoma of the descending thoracic aorta. Axial pre- (a) and post-contrast enhanced (b, c) images show heterogeneous attenuated mass broadly attached to the descending thoracic aorta (white arrows). The mass shows no significant enhancement on CT images. There is a small ulcer-like projection at the inferior portion of the mass (black arrow on c).

• 

  Fig. 2 Thoracic MR images of the patient. Axial T1-weighted (a) and T2-weighted (b) images show the mass of the descending thoracic aorta with heterogeneous signal intensity (white arrows). Axial T1-weighted, fat-saturated pre- (c) and post-contrast image (d), subtraction images (e, f) show peripheral rim and small nodular enhancement of the mass (white arrows), which was not shown on CT images.

• 

  Fig. 3 PET-CT and microscopic findings of the patient. Axial PET-CT image (a) shows the FDG hypermetabolism on the periphery of the mass (white arrows), corresponding to enhancing portions on MRI. The pathologic finding (b) shows that the tumor is composed of short spindle pleomorphic cells with prominent nucleoli and high mitotic rates (Hematoxylin & Eosin stain, × 40).

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