Aortic angiosarcoma masquerading as a thoracic aortic aneurysm

Aortic angiosarcoma is an exceedingly rare clinical entity. Significant delay in diagnosis can occur due to a low index of suspicion on the part of the clinician. We report a case of aortic angiosarcoma masquerading as a descending thoracic aneurysm arising from a penetrating ulcer. The patient was initially treated with an endovascular stent graft for rapid growth, but the lesion continued to enlarge despite angiographic exclusion. FDG-PET CT scan and biopsy ultimately confirmed the diagnosis of aortic angiosarcoma. This case highlights some of the difficulties of making the early diagnosis of aortic angiosarcoma.