Primary aortic sarcoma

A 64-year-old woman with an aortic mass experienced repeated recurrences of stroke (figure 1) and died 8 months later. The postmortem examination showed the tumor to almost completely obstruct the aortic lumen, while extending to the intracranial arteries without parenchymal invasion (figure 2). The pathologic diagnosis was undifferentiated aortic intimal sarcoma. Primary aortic sarcoma is a rare and aggressive tumor, with clinical symptoms including acute arterial embolism and disseminated metastasis.1 Although arch atheroma is sometimes identified as a cause of cerebral emboli,2 this case shows that primary aortic sarcoma should be included in the differential diagnosis of aortic arch diseases.