Aortic intimal sarcoma with abdominal metastasis: case report and management approach

BackgroundAortic intimal sarcoma is an exceptionally rare malignancy with a poor prognosis. Tumors are predominantly located in the abdominal aorta, thoracic aorta, and thoracoabdominal aorta. Abdominal metastasis of aortic sarcoma is rarely documented, and effective treatment regimens are lacking.C...

Full description

Saved in:
Bibliographic Details
Main Authors: Gongji Yao, Jianwei Xu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1508691/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1823856565712584704
author Gongji Yao
Gongji Yao
Jianwei Xu
Jianwei Xu
author_facet Gongji Yao
Gongji Yao
Jianwei Xu
Jianwei Xu
author_sort Gongji Yao
collection DOAJ
description BackgroundAortic intimal sarcoma is an exceptionally rare malignancy with a poor prognosis. Tumors are predominantly located in the abdominal aorta, thoracic aorta, and thoracoabdominal aorta. Abdominal metastasis of aortic sarcoma is rarely documented, and effective treatment regimens are lacking.Case presentationA 55-year-old female presented with recurrent abdominal pain and a history of hypertension and mesenteric thrombosis. Initial arterial computed tomography angiography (CTA) revealed multiple thrombi with significant luminal narrowing, leading to a diagnosis of aortic thrombosis. She was referred to the First Affiliated Hospital of Zhejiang University for surgical intervention. Pathological analysis confirmed a diagnosis of aortic intimal sarcoma with MDM2 positivity. One month later, the patient developed severe abdominal pain, and positron emission tomography-computed tomography (PET-CT) showed accumulation in the small intestine, jejunum, and back muscles. Palliative tumor removal was performed, and the patient received chemotherapy with platinum drugs and epirubicin. Post-treatment PET-CT indicated no significant tumor staining or progression.DiscussionAortic intimal sarcoma is a rare neoplasm with limited treatment options. MDM2 overexpression is commonly observed, but similar histological features can appear in other conditions, making diagnosis challenging. Imaging modalities, including MRI and PET-CT, are crucial for diagnosis and monitoring. Current treatment strategies are non-standardized, but small-molecule inhibitors targeting MDM2 show promise. This case highlights the potential effectiveness of combined surgical and chemotherapeutic approaches for managing abdominal metastasis of aortic intimal sarcoma and provides a foundation for future clinical trials.
format Article
id doaj-art-28a4dd51959d44aea4b0622e38b4983e
institution Kabale University
issn 2234-943X
language English
publishDate 2025-02-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Oncology
spelling doaj-art-28a4dd51959d44aea4b0622e38b4983e2025-02-12T07:25:44ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-02-011510.3389/fonc.2025.15086911508691Aortic intimal sarcoma with abdominal metastasis: case report and management approachGongji Yao0Gongji Yao1Jianwei Xu2Jianwei Xu3Department of Intervention, Huzhou Central Hospital, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, Zhejiang, ChinaDepartment of Intervention, Huzhou Central Hospital, The Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, ChinaDepartment of Intervention, Huzhou Central Hospital, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, Zhejiang, ChinaDepartment of Intervention, Huzhou Central Hospital, The Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, ChinaBackgroundAortic intimal sarcoma is an exceptionally rare malignancy with a poor prognosis. Tumors are predominantly located in the abdominal aorta, thoracic aorta, and thoracoabdominal aorta. Abdominal metastasis of aortic sarcoma is rarely documented, and effective treatment regimens are lacking.Case presentationA 55-year-old female presented with recurrent abdominal pain and a history of hypertension and mesenteric thrombosis. Initial arterial computed tomography angiography (CTA) revealed multiple thrombi with significant luminal narrowing, leading to a diagnosis of aortic thrombosis. She was referred to the First Affiliated Hospital of Zhejiang University for surgical intervention. Pathological analysis confirmed a diagnosis of aortic intimal sarcoma with MDM2 positivity. One month later, the patient developed severe abdominal pain, and positron emission tomography-computed tomography (PET-CT) showed accumulation in the small intestine, jejunum, and back muscles. Palliative tumor removal was performed, and the patient received chemotherapy with platinum drugs and epirubicin. Post-treatment PET-CT indicated no significant tumor staining or progression.DiscussionAortic intimal sarcoma is a rare neoplasm with limited treatment options. MDM2 overexpression is commonly observed, but similar histological features can appear in other conditions, making diagnosis challenging. Imaging modalities, including MRI and PET-CT, are crucial for diagnosis and monitoring. Current treatment strategies are non-standardized, but small-molecule inhibitors targeting MDM2 show promise. This case highlights the potential effectiveness of combined surgical and chemotherapeutic approaches for managing abdominal metastasis of aortic intimal sarcoma and provides a foundation for future clinical trials.https://www.frontiersin.org/articles/10.3389/fonc.2025.1508691/fullaortic intimal sarcomaabdominal metastasisMDM2chemotherapyPET-CTMRI
spellingShingle Gongji Yao
Gongji Yao
Jianwei Xu
Jianwei Xu
Aortic intimal sarcoma with abdominal metastasis: case report and management approach
Frontiers in Oncology
aortic intimal sarcoma
abdominal metastasis
MDM2
chemotherapy
PET-CT
MRI
title Aortic intimal sarcoma with abdominal metastasis: case report and management approach
title_full Aortic intimal sarcoma with abdominal metastasis: case report and management approach
title_fullStr Aortic intimal sarcoma with abdominal metastasis: case report and management approach
title_full_unstemmed Aortic intimal sarcoma with abdominal metastasis: case report and management approach
title_short Aortic intimal sarcoma with abdominal metastasis: case report and management approach
title_sort aortic intimal sarcoma with abdominal metastasis case report and management approach
topic aortic intimal sarcoma
abdominal metastasis
MDM2
chemotherapy
PET-CT
MRI
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1508691/full
work_keys_str_mv AT gongjiyao aorticintimalsarcomawithabdominalmetastasiscasereportandmanagementapproach
AT gongjiyao aorticintimalsarcomawithabdominalmetastasiscasereportandmanagementapproach
AT jianweixu aorticintimalsarcomawithabdominalmetastasiscasereportandmanagementapproach
AT jianweixu aorticintimalsarcomawithabdominalmetastasiscasereportandmanagementapproach