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Case Reports
. 2025 Jun 6;19(1):268.
doi: 10.1186/s13256-025-05329-5.

Undifferentiated pleomorphic sarcoma invading thoracic aorta treated by thoracic endovascular aortic repair: a case report

Haiyang Li  1 , Qihua Gong  2 , Wei Wei  2
Affiliations
Case Reports

Undifferentiated pleomorphic sarcoma invading thoracic aorta treated by thoracic endovascular aortic repair: a case report

Haiyang Li et al. J Med Case Rep. .

Abstract

Background: Undifferentiated pleomorphic sarcoma arising from the posterior mediastinum and infiltrating the thoracic aorta is exceptionally rare, with few cases reported in scientific literature.

Case presentation: A 48-year-old Han Chinese man was admitted with persistent chest pain for 2 months; he had not received a diagnosis or treatment plan from the previous hospital. Firstly, thoracic endovascular aortic repair surgery was performed to safeguard the integrity of the thoracic aorta, followed by a biopsy to confirm undifferentiated pleomorphic sarcoma. A chemotherapy plan was then established on the basis of the latest pathological results.

Conclusion: Undifferentiated pleomorphic sarcoma is highly malignant, complicating diagnosis and treatment and often resulting in a poor prognosis. Invasion of the posterior mediastinum and aorta is exceptionally rare. An early thoracic endovascular aortic repair intervention to protect the aorta and cut tumor blood supply, followed by needle biopsy for diagnosis, offers an innovative approach that can guide clinical practice.

Keywords: Case report; Thoracic aorta; Thoracic endovascular aortic repair (TEVAR); Undifferentiated pleomorphic sarcoma (UPS).

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study has been approved by the Ethics Committee of Guiqian International General Hospital. Consent for publication: Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests: The authors declare no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Preoperative enhanced computed tomography scan image showing two tumors in the posterior mediastinum and the left one invading the thoracic aorta (the red arrow indicates the primary site of the tumor along with its infiltration into the aorta)
Fig. 2
Fig. 2
Single photon emission computed tomography/computed tomography indicated multiple bone metastasis (the red arrow demarcates the osteolytic metastasis in the bilateral ribs)
Fig. 3
Fig. 3
Disappearance of enhancement shadow of the original descending aorta process after thoracic endovascular aortic repair surgery (the red arrow demarcates the postoperative tumor bed and absence of contrast enhancement along the aortic adventitial plane)
Fig. 4
Fig. 4
A Pathological findings showing a polymorphic to storiform pattern with a myxoid and collagenous matrix (hematoxylin and eosin stain 40X); B immunohistochemical results (tumor cells): CK (less +), vimentin (+), calretinin (−), S-100 (−), Ki-67 (50% +), SMA (partially +), desmin (−), CD34 (−), CD5 (−), CD117 (c-kit; −, control), CD45 (LCA; −), Brg-1 (+, not missing), INI-1 (+, not missing), SOX-10 (−), caidesmon (−), and myogenin (−)
Fig. 5
Fig. 5
The results of quarterly chest computed tomography follow-ups demonstrated a significant reduction in tumor size bilaterally
See this image and copyright information in PMC

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