A rare case of acute arterial thrombosis revealing undifferentiated arterial leiomyosarcoma

Aortic leiomyosarcoma, a rare and elusive malignancy, presents diagnostic and therapeutic dilemmas due to its nonspecific symptoms and aggressive course. We report a unique case where the incidental discovery of arterial leiomyosarcoma occurred during acute cerebral infarction management. A previous...

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Main Authors: Masato Tsuchimochi, Shigeta Miyake, Taisuke Akimoto, Yuta Otomo, Yasunobu Nakai, Kotaro Oshio, Tetsuya Yamamoto
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Annals of Vascular Surgery - Brief Reports and Innovations
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772687825000066
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author Masato Tsuchimochi
Shigeta Miyake
Taisuke Akimoto
Yuta Otomo
Yasunobu Nakai
Kotaro Oshio
Tetsuya Yamamoto
author_facet Masato Tsuchimochi
Shigeta Miyake
Taisuke Akimoto
Yuta Otomo
Yasunobu Nakai
Kotaro Oshio
Tetsuya Yamamoto
author_sort Masato Tsuchimochi
collection DOAJ
description Aortic leiomyosarcoma, a rare and elusive malignancy, presents diagnostic and therapeutic dilemmas due to its nonspecific symptoms and aggressive course. We report a unique case where the incidental discovery of arterial leiomyosarcoma occurred during acute cerebral infarction management. A previously healthy 58-year-old woman, initially presenting with severe neurological deficits indicative of acute ischemic stroke, underwent prompt recanalization therapy that resulted in successful restoration. Unexpectedly, a histopathological examination of the extracted thrombus revealed arterial leiomyosarcoma. The diagnostic process involved immunohistochemistry and contrast-enhanced computed tomography, confirming the presence of leiomyosarcoma originating from the ascending aorta. Given the patient's severe disability, a palliative care approach was chosen to prioritize comfort and quality of life. This case underscores the diagnostic potential of acute recanalization therapy for functional recovery as well as histopathological examination, shedding light on rare diseases. Further case accumulation is essential to refine treatment strategies and improve prognostic outcomes for vascular sarcomas.
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publishDate 2025-03-01
publisher Elsevier
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series Annals of Vascular Surgery - Brief Reports and Innovations
spelling doaj-art-3f6a87adc9d0479eae35e1f772a39b632025-08-20T02:52:20ZengElsevierAnnals of Vascular Surgery - Brief Reports and Innovations2772-68782025-03-015110036510.1016/j.avsurg.2025.100365A rare case of acute arterial thrombosis revealing undifferentiated arterial leiomyosarcomaMasato Tsuchimochi0Shigeta Miyake1Taisuke Akimoto2Yuta Otomo3Yasunobu Nakai4Kotaro Oshio5Tetsuya Yamamoto6Department of Neurosurgery, Yokohama Brain and Spine Center, 1-2-1, Takigashira, Isogo, Yokohama, Kanagawa, 2350012, Japan; Department of Neurosurgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, JapanDepartment of Neurosurgery, Yokohama Brain and Spine Center, 1-2-1, Takigashira, Isogo, Yokohama, Kanagawa, 2350012, Japan; Department of Neurosurgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, Japan; Corresponding author at: Department of Neurosurgery, Yokohama Brain and Spine Center, 1-2-1, Takigashira, Isogo, Yokohama, Kanagawa, 2350012, Japan.Department of Neurosurgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, JapanDepartment of Neurosurgery, Yokohama Brain and Spine Center, 1-2-1, Takigashira, Isogo, Yokohama, Kanagawa, 2350012, Japan; Department of Neurosurgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, JapanDepartment of Neurosurgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, JapanDepartment of Neurosurgery, Yokohama Brain and Spine Center, 1-2-1, Takigashira, Isogo, Yokohama, Kanagawa, 2350012, JapanDepartment of Neurosurgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, JapanAortic leiomyosarcoma, a rare and elusive malignancy, presents diagnostic and therapeutic dilemmas due to its nonspecific symptoms and aggressive course. We report a unique case where the incidental discovery of arterial leiomyosarcoma occurred during acute cerebral infarction management. A previously healthy 58-year-old woman, initially presenting with severe neurological deficits indicative of acute ischemic stroke, underwent prompt recanalization therapy that resulted in successful restoration. Unexpectedly, a histopathological examination of the extracted thrombus revealed arterial leiomyosarcoma. The diagnostic process involved immunohistochemistry and contrast-enhanced computed tomography, confirming the presence of leiomyosarcoma originating from the ascending aorta. Given the patient's severe disability, a palliative care approach was chosen to prioritize comfort and quality of life. This case underscores the diagnostic potential of acute recanalization therapy for functional recovery as well as histopathological examination, shedding light on rare diseases. Further case accumulation is essential to refine treatment strategies and improve prognostic outcomes for vascular sarcomas.http://www.sciencedirect.com/science/article/pii/S2772687825000066Undifferentiated arterial leiomyosarcomaMechanical thrombectomyPathologyLeiomyosarcoma
spellingShingle Masato Tsuchimochi
Shigeta Miyake
Taisuke Akimoto
Yuta Otomo
Yasunobu Nakai
Kotaro Oshio
Tetsuya Yamamoto
A rare case of acute arterial thrombosis revealing undifferentiated arterial leiomyosarcoma
Annals of Vascular Surgery - Brief Reports and Innovations
Undifferentiated arterial leiomyosarcoma
Mechanical thrombectomy
Pathology
Leiomyosarcoma
title A rare case of acute arterial thrombosis revealing undifferentiated arterial leiomyosarcoma
title_full A rare case of acute arterial thrombosis revealing undifferentiated arterial leiomyosarcoma
title_fullStr A rare case of acute arterial thrombosis revealing undifferentiated arterial leiomyosarcoma
title_full_unstemmed A rare case of acute arterial thrombosis revealing undifferentiated arterial leiomyosarcoma
title_short A rare case of acute arterial thrombosis revealing undifferentiated arterial leiomyosarcoma
title_sort rare case of acute arterial thrombosis revealing undifferentiated arterial leiomyosarcoma
topic Undifferentiated arterial leiomyosarcoma
Mechanical thrombectomy
Pathology
Leiomyosarcoma
url http://www.sciencedirect.com/science/article/pii/S2772687825000066
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