Key result
Aortic angiosarcoma mimics vascular graft infection five years post-EVAR and requires surgical resection with chemotherapy.
Case Report (n=1)
Primary angiosarcoma of the abdominal aorta can mimic vascular graft infection following EVAR, highlighting the need for multimodal imaging and biopsy in equivocal cases.
Consider angiosarcoma in atypical post-EVAR graft infections; extends differential for hypermetabolic aortic masses.
A 64-year-old woman presented with recurrent abdominal pain and rapid weight loss of 10 kg. Five years prior, an abdominal endovascular aneurysm repair (EVAR) was performed, followed by an open repair with proximal graft interposition due to an endoleak type IA two years ago. Laboratory tests revealed only moderately elevated infection markers (CrP 66 mg/L, WBC 14 GPt/L). 18F-FDG PET/CT showed a hypermetabolic peri-aortic mass initially suspected to be inflammatory. However, the patient did not exhibit signs of fever. Because of the equivocal constellation, a fine-needle biopsy was conducted, revealing malignant cells. The patient underwent complete tumor resection including aortic replacement. Histopathology confirmed the diagnosis of an angiosarcoma. The treatment was then supplemented with chemotherapy using doxorubicin and ifosfamide.
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Wehmann et al. (2026) conducted a case report in Primary angiosarcoma of the abdominal aorta (n=1). Tumor resection, aortic replacement, and chemotherapy was evaluated. A 64-year-old woman was diagnosed with an epithelioid angiosarcoma of the abdominal aorta mimicking a vascular graft infection five years after EVAR, treated with surgical resection and chemotherapy.
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