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J Thorac Cardiovasc Surg 2010;139:e40-e42
© 2010 The American Association for Thoracic Surgery

Brief Clinical Report

Angiosarcoma in the aortic arch presented as repeat strokes

^a Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, and Chang Gung University, College of Medicine, Linkou and Chia-Yi, Taiwan
^b Department of Medial Image and Intervention, Chang Gung Memorial Hospital, and Chang Gung University, College of Medicine, Linkou and Chia-Yi, Taiwan
^c Department of Pathology, Chang Gung Memorial Hospital, and Chang Gung University, College of Medicine, Linkou and Chia-Yi, Taiwan
^d Department of Oncology, Chang Gung Memorial Hospital, and Chang Gung University, College of Medicine, Linkou and Chia-Yi, Taiwan
^e Graduate Institute of Clinical Medicines, College of Medicine, Taipei Medical University, Taipei, Taiwan

Received for publication August 28, 2008; revisions received September 28, 2008; accepted for publication October 16, 2008.

^_* Address for reprints: Yao-Kuang Huang, MD, Division of Cardiac Surgery, Chang Gung Memorial Hospital, Linkou, and Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, 5, Fu-Shin Rd, Kwei-Shan, Taoyuan, Taiwan 33377. (Email: huang137@mac.com).

The first 20% of the full text of this article appears below.

	Introduction

 
A 51-year-old man visited a local medical clinic 4 weeks before admission because of a 6-month history of weight loss and anorexia. His medical history was unremarkable except for a blood pressure discrepancy in both arms on physical examination. Furthermore, a palpable abdominal mass was found and proved later to be a probable malignant adrenal tumor by means of abdominal computed tomographic analysis.

He experienced several episodes of unconsciousness with cyanotic apnea, which required brief resuscitation and mechanical ventilator support. An unusual mass inside the innominate artery was discovered in a brain computed tomographic scan to exclude intracranial pathology. The mass had occluded the innominate artery completely with compression of the left carotid artery (Figure 1 ). Advanced malignant disease was suspected, and palliative surgical bypass was designed to avoid further brain embolic or ischemic events. The ascending aorta was approached through a median sternotomy, and both carotid arteries were explored with oblique incisions . . . [Full Text of this Article]