Descending aortic stenosis caused by intramural thrombus in the setting of severe thrombocytosis: a rare mimicker of aortic angiosarcoma.

Q4 Medicine

Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2025-05-07 DOI:10.1510/mmcts.2025.025

Susumu Oshima, Hirokami Tomohiro, Sakurai Shigeru

{"title":"Descending aortic stenosis caused by intramural thrombus in the setting of severe thrombocytosis: a rare mimicker of aortic angiosarcoma.","authors":"Susumu Oshima, Hirokami Tomohiro, Sakurai Shigeru","doi":"10.1510/mmcts.2025.025","DOIUrl":null,"url":null,"abstract":"<p><p>A rare case of descending aortic stenosis caused by intramural thrombus in a patient with severe thrombocytosis is presented. A 50-year-old man exhibited progressive bilateral claudication. Imaging revealed a suspicious intramural lesion with no significant enhancement on positron emission tomography-computed tomography scans. Because primary aortic angiosarcoma could not be excluded, an oncological surgical strategy was used. The lesion was removed en bloc without luminal entry, and a 22-mm Dacron graft was used for reconstruction. Histopathological analysis confirmed thrombus without malignancy. Postoperative recovery was uneventful, with resolution of claudication, normalization of the ankle-brachial index (ABI) and ongoing cytoreductive therapy for confirmed essential thrombocythaemia. This case highlights the importance of considering haematologic disorders in aortic pathology and demonstrates a safe surgical strategy in diagnostically uncertain cases.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":"2025 ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1510/mmcts.2025.025","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

Abstract

A rare case of descending aortic stenosis caused by intramural thrombus in a patient with severe thrombocytosis is presented. A 50-year-old man exhibited progressive bilateral claudication. Imaging revealed a suspicious intramural lesion with no significant enhancement on positron emission tomography-computed tomography scans. Because primary aortic angiosarcoma could not be excluded, an oncological surgical strategy was used. The lesion was removed en bloc without luminal entry, and a 22-mm Dacron graft was used for reconstruction. Histopathological analysis confirmed thrombus without malignancy. Postoperative recovery was uneventful, with resolution of claudication, normalization of the ankle-brachial index (ABI) and ongoing cytoreductive therapy for confirmed essential thrombocythaemia. This case highlights the importance of considering haematologic disorders in aortic pathology and demonstrates a safe surgical strategy in diagnostically uncertain cases.

查看原文本刊更多论文

严重血小板增多症下由壁内血栓引起的降主动脉狭窄：一种罕见的主动脉血管肉瘤的模拟物。

本文报告一例罕见的由壁内血栓引起的降主动脉瓣狭窄。50岁男性表现进行性双侧跛行。影像显示可疑的体壁内病变，正电子发射断层扫描和计算机断层扫描未见明显增强。由于原发性主动脉血管肉瘤不能排除，因此采用肿瘤手术策略。病变整体切除，不经腔内进入，用22毫米涤纶移植物重建。组织病理学分析证实血栓无恶性。术后恢复顺利，跛行消退，踝臂指数（ABI）恢复正常，并对原发性血小板血症进行了持续的细胞减少治疗。本病例强调了在主动脉病理中考虑血液学疾病的重要性，并在诊断不确定的病例中展示了安全的手术策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Medicine-Medicine (all)

CiteScore

0.60

自引率

0.00%

发文量

期刊介绍： The Multimedia Manual of Cardio-Thoracic Surgery (MMCTS) is produced by The European Association for Cardio-Thoracic Surgery (EACTS). MMCTS is the world’s premier video-based educational resource for cardiovascular and thoracic surgeons; freely accessible - and essential - for all. MMCTS was launched more than ten years ago under the leadership of founding editor Professor Marko Turina. It was Professor Turina’s vision that the European Association for Cardio-Thoracic Surgery (EACTS), already the world-leader in CT surgery education, should take advantage of the Internet’s rapidly improving video publication capabilities and create a new step-by-step manual of surgical procedures. Professor Turina and EACTS agreed that the manual, MMCTS, should be freely accessible to all users, regardless of association membership status, nationality, or affiliation. MMCTS was self-published by EACTS for some years before being transferred to Oxford University Press, which hosted it until the end of 2016. In November 2016, the Manual returned home to EACTS and it has now relaunched in a completely new format. Since its birth in 2005, MMCTS has published some 400 detailed, video-based demonstrations of cardio-thoracic surgical procedures. Tutorials published prior to 2012 have been archived and we are working with the authors of these tutorials to update their work pending republication on the new site. Our mission is to make MMCTS the best online reference for cardio-thoracic surgeons – residents and experienced surgeons alike. Our aim is to include tutorials presenting procedures at both a fundamental and an advanced level. Truly innovative procedures are also included and are identified as such.