MASSIVE OSTEOLYTIC BONE METASTASES FROM A PRIMARY AORTIC SARCOMA - A CASE-REPORT

We present an unusual case of an aortic intimal sarcoma, which origina lly manifested itself by the presence of extensive radiologically oste olytic lesions in the long bones of the low er Limbs. The histology of these was puzzling and was first considered to represent a low grade sarcoma of vasoformative tissue and subsequently skeletal angiomatosis . Despite a good initial clinical response to disodium etidronate, the patient ultimately developed small bowel infarction and the true diag nosis only came to light at autopsy. This revealed a tumour in the low er thoracic aorta which, unusually for aortic sarcoma, consisted of lo osely packed bland spindle cells with no necrosis and infrequent mitos es. Immunocytochemistry was unhelpful but electron microscopy suggeste d myofibroblastic differentiation. The majority of previous reports of the tumour in the literature lack information on electron microscopy and immunocytochemistry and have suggested that these tumours are gene rally pleomorphic in appearance. Embolic phenomena and post mortem dia gnosis are usual although occasional antemortem diagnosis has been mad e using computed tomography (CT) and magnetic resonance imaging (MRI) scanning with the latter being the investigation of choice. Copyright (C) 1997 by W.B. Saunders Company.