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Peer-reviewedCC BYFrontiers in surgery

Abdominal aortic angiosarcoma following endovascular aneurysm repair: case report and analysis of existing literature.

  • Loes H Willems1
  • Marcus Steinbach2
  • Daniel Pink3,4
  • Thomas Herold5
  • Alexander Meyer1,6
  • Roger Wahba2
6 affiliations
  1. 1Clinic of Vascular Surgery, Helios Klinikum Berlin-Buch, Berlin, Germany.
  2. 2Clinic of General, Visceral and Oncological Surgery, Helios Klinikum Berlin-Buch, Berlin, Germany.
  3. 3Department of Oncology and Palliative Care, Helios Klinikum Berlin-Buch, Berlin, Germany.
  4. 4Department of Internal Medicine, University Hospital Greifswald, Greifswald, Germany.
  5. 5Clinic of Diagnostic and Interventional Radiology, Helios Klinikum Berlin-Buch, Berlin, Germany.
  6. 6Medical School Berlin, Berlin, Germany.
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Abstract

Abdominal aortic angiosarcoma following endovascular aneurysm repair (EVAR) is an exceptionally rare and aggressive malignancy that may mimic common EVAR-related complications. We report the case of a 72-year-old man who presented with progressive lower back pain and was initially suspected of having a graft infection. Imaging revealed a periaortic mass involving a previously treated abdominal aortic aneurysm. Biopsy confirmed aortic angiosarcoma. No regional lymph node or distant metastases were identified. The patient underwent neoadjuvant chemotherapy with gemcitabine and docetaxel, followed by radiotherapy and surgical resection of the abdominal aorta and EVAR graft with aortic reconstruction. Histopathological examination demonstrated complete pathological response without evidence of residual angiosarcoma. Our literature review identified only 21 reported cases of abdominal aortic angiosarcoma following EVAR, including the present case, underscoring the exceptional rarity of this entity and the limited evidence available to guide diagnosis and treatment. This case highlights the importance of considering aortic angiosarcoma in patients with persistent symptoms and atypical periaortic findings after EVAR and suggests that early biopsy and a multidisciplinary, multimodal treatment approach may improve outcomes despite the generally poor prognosis associated with this disease.

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Cite

BibTeXRIS
BibTeX
@article{willems2026abdominal,
  title = {{Abdominal aortic angiosarcoma following endovascular aneurysm repair: case report and analysis of existing literature.}},
  author = {Loes H Willems and Marcus Steinbach and Daniel Pink and Thomas Herold and Alexander Meyer and Roger Wahba},
  journal = {Frontiers in surgery},
  year = {2026},
  month = oct,
  doi = {10.3389/fsurg.2026.1972877},
  url = {https://europepmc.org/article/MED/42952852},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Abdominal aortic angiosarcoma following endovascular aneurysm repair: case report and analysis of existing literature.
AU  - Loes H Willems
AU  - Marcus Steinbach
AU  - Daniel Pink
AU  - Thomas Herold
AU  - Alexander Meyer
AU  - Roger Wahba
PY  - 2026
DA  - 2026/10/14
JO  - Frontiers in surgery
DO  - 10.3389/fsurg.2026.1972877
UR  - https://europepmc.org/article/MED/42952852
AB  - Abdominal aortic angiosarcoma following endovascular aneurysm repair (EVAR) is an exceptionally rare and aggressive malignancy that may mimic common EVAR-related complications. We report the case of a 72-year-old man who presented with progressive lower back pain and was initially suspected of having a graft infection. Imaging revealed a periaortic mass involving a previously treated abdominal aortic aneurysm. Biopsy confirmed aortic angiosarcoma. No regional lymph node or distant metastases were identified. The patient underwent neoadjuvant chemotherapy with gemcitabine and docetaxel, followed by radiotherapy and surgical resection of the abdominal aorta and EVAR graft with aortic reconstruction. Histopathological examination demonstrated complete pathological response without evidence of residual angiosarcoma. Our literature review identified only 21 reported cases of abdominal aortic angiosarcoma following EVAR, including the present case, underscoring the exceptional rarity of this entity and the limited evidence available to guide diagnosis and treatment. This case highlights the importance of considering aortic angiosarcoma in patients with persistent symptoms and atypical periaortic findings after EVAR and suggests that early biopsy and a multidisciplinary, multimodal treatment approach may improve outcomes despite the generally poor prognosis associated with this disease.
SN  - 2296-875X
ER  -