AORTIC INTIMAL SARCOMA WITH ACUTE MYOCARDIAL-INFARCTION

An autopsy case of aortic sarcoma who died of acute myocardial infarct ion caused by coronary involvement is reported. The patient was a 54 y ear old woman who was admitted because of an undiagnosed fever and gen eral fatigue of 6 months duration. Magnetic resonance imaging (MRI) sh owed a tumor in the aortic arch. Total aortic arch replacement was per formed. It was diagnosed as a malignant mesenchymal tumor of the aorta . The patient died of acute myocardial infarction 10 months after the operation. At autopsy, the tumor had invaded the luminal surface and i ntima of the proximal anastomosis (the remnant ascending aorta and the graft), the aortic valves, the distal anastomosis (surgical line of t he thoracic aorta plus the graft), and the coronary arteries. The left main coronary artery showed complete obstruction by fibrin thrombus w ith tumor invasion in the intima, which was responsible for acute myoc ardial infarction. Primitive and bizarre tumor cells proliferated with many slit-like tissue spaces. Most of the tumor except for its lumina l surface showed necrosis. Ultrastructurally, there were spaces betwee n tumor cells, suggesting lumen formation, and some of them had microv illi. This sarcoma was considered to be the so-called aortic intimal s arcoma.