An intra-aortic floating metastatic malignancy of unknown primary origin

作者：Kuroda Yoshinori^*; Uchida Tetsuro; Hayashi Jun; Sadahiro Mitsuaki

来源：European Journal of Cardio-Thoracic Surgery, 2018, 53(2): 477-478.

DOI：10.1093/ejcts/ezx306

• Intra-aortic tumour
• Metastatic aortic tumour
• Intra-aortic floating mass

A 69-year-old man with sudden strong back pain was transported to our hospital by ambulance. The computed tomography scan revealed an intra-aortic floating mass with a stalk arising from the descending aortic wall, which was thought to be a thrombus. The floating mass displayed the characteristics of a thrombus rather than a neoplastic tumour on magnetic resonance imaging scan. Under extracorporeal circulation, the descending aorta was cut open, and the mass was resected. Subsequently, a stent graft was placed to cover the abnormal aortic intima to prevent recurrent thrombus formation. The pathological diagnosis revealed an adenocarcinoma, not a thrombus. We could not detect the origin of malignancy despite additional examinations. Brain metastasis developed, and the patient died of recurrent pneumonia and urinary tract infection. These findings emphasize the importance of a precise plan of action for rare diseases.

• 出版日期2018-2