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Sarcoma arising from a popliteal artery aneurysm: historical case report

W. I. B. Onuigbo

Department of Pathology, Medical Foundation and Clinic, Enugu, Nigeria

E-mail : wilson.onuigbo@gmail.com

DOI: 10.15761/CCRR.1000120

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Abstract

Single rare case of sarcoma arising from an aortic aneurismal sac was reported in 2006 and 2012. Another case appeared a decade earlier. Therefore, this paper abridges a case reported fully in 1890 on account of its historical interest.

Introduction

It is acknowledged that sarcoma arising in an arterial aneurysm is rare [1-3]. They have been diagnosed after surgery with histologic confirmation. Accordingly, I report the 1890 case abridge from the Transactions of the Pathological Society of London, especially as it was subjected, as in the current practice, to independent microscopic opinion [4].

Case report

A 71-year-old man was admitted to St. Thomas’s Hospital, London, on 4th June, 1888, with popliteal aneurysm in the left leg. The patient complained of a small lump in the ham which pulsated strongly. It increased rapidly to double its size. It was repeatedly examined by many doctors and none doubted that the tumor was caused by an areusym. He was ligated successfully. However, three months later, he was suffering severely from pain caused by the increasing swelling in the ham. The decision was “to explore the popliteal tumour with the object of ascertaining whether the local lesion was due to liquefaction of the contents of the aneurysm and inflammation around it, or whether the aneurysm had become complicated by a new growth.” The limb was amputated. The stump healed quickly, and the man left the hospital at the end of a month. He survived until about a year, when he died of recurrence of the malignant disease. The limb was hardened in spirit and underwent extensive careful examination. It was concluded that the case was one of aneurysm which became complicated by a rapid growth of sarcoma. As was the practice of The Pathological Society of London, its 3-man Morbid Growths Committee examined the materials. Their opinion was convincing thus:

There is evidence to show that the aneurysm is of longer standing than the sarcoma, and the changes in the vessel wall are not such as would result merely from infiltration by new growth. The popliteal artery is dilated for a considerable distance, and shows atheromatous changes which are evidently old. The sarcoma, on the other hand, shows no extensive degenerative changes, such as are frequently met within tumours of this nature which have existed for a considerable time.

Discussion

Primary tumors of the aorta are extremely rare and the diagnosis is usually made after surgery or autopsy [1-3]. Incidentally, the medical masters of yester years were at pains to present such rare cases before the London Society. In the extant case [4], it was published because the author could not “find any record of any strictly comparable case or specimen.” Moreover, the report was made because “it may possibly assist in bringing to light some other, similarly obscure and interesting cases.”

With regard to survival after the occurrence of arterial sarcoma, the median rate was reported as 7 months [1]. Therefore, the one year interval in this historical case is noteworthy.

Moreover, illustrative cases had hitherto been confined to the abdominal aorta [1-3]. Rarely, bilateral femoral artery aneurysm mimicked soft tissue sarcoma [5]. The historical case is unique, therefore, on the ground that a peripheral artery was involved.

References

  1. Defawe OD, Thiry A, Lapiere CM, Limet R, Sakalihasan N (2006) Primary sarcoma of an abdominal aortic aneurysm. Abdom Imaging 31: 117-119. [Crossref]
  2. Compagnoni G, Matsumura JS, Nemcek A, McCarthy WJ (1997) Sarcoma arising from an abdominal aortic aneurysm. Ann Vasc Surg 11: 183-185. [Crossref]
  3. Garg N, Lewis MA, Maleszewski JJ, Kalra M (2012) Intimal sarcoma in an inflammatory aneurysm after endovascular aneurysm repair. J Vasc Surg 55: 1134-1137. [Crossref]
  4. Croft J (1890) Aneurysm of the popliteal artery complicated with sarcoma. Trans Pathol Soc Lond 41: 65-70.
  5. Adeoye PO, Adebola SO, Adesiyun OA, Braimoh KT (2012) Bilateral femoral artery aneurysm mimicking soft tissue sarcoma. Ann Vasc Surg 26: 279. [Crossref]

Editorial Information

Editor-in-Chief

Massimo Fioranelli
Guglielmo Marconi University

Article Type

Case Report

Publication history

Received date: March 06, 2015
Accepted date: April 10, 2015
Published date: April 13, 2015

Copyright

©2015 Onuigbo WIB. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Citation

Onuigbo WIB (2015). Sarcoma arising from a popliteal artery aneurysm: historical case report. Clin Case Rep Rev 1: doi: 10.15761/CCRR.1000120

Corresponding author

W. I. B. Onuigbo

Department of Pathology, Medical Foundation and Clinic, Enugu, Nigeria.

E-mail : wilson.onuigbo@gmail.com

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