FDG PET/CT in Aortic Angiosarcoma

A 62-year-old woman was referred for general fatigue, left lower limb pain, and increased inflammatory blood markers. Computed tomography (CT) demonstrated an intraluminal tumor in the distal portion of the thoracic aorta, which was confirmed by magnetic resonance imaging (MRI) with mild enhancement after gadolinium injection. Fluorodeoxyglucose/positron emission tomography/CT (FDG PET/CT) showed increased uptake at the location corresponding to the tumor and at the upper extremity of the left femur. Bone biopsy revealed a benign reactive fibrohistiocytic proliferation, whereas subsequent intravascular biopsy of the aortic mass studied by immunohistochemical method revealed a pattern suggestive of intimal angiosarcoma. Surgical treatment was refused by the patient because of the high risk of paraplegia.