Aortic intimal sarcoma mimicking a mycotic pararenal abdominal aortic aneurysm

We present a case of aortic intimal sarcoma mimicking a mycotic para-renal abdominal aortic aneurysm, treated with staged hybrid surgery. A 60-year-old female presented with complaints of nausea and back pain. Computed tomography showed a para-renal abdominal aortic aneurysm with irregular and multilobulated shape, without periaortic soft-tissue inflammation, occlusion of the celiac artery, and stenosis of the superior mesenteric artery. She underwent superior mesenteric artery stenting, followed by aortic resection and axillo-femoral bypass for suspicion of mycotic aortic aneurysm. Pathologic examination revealed aortic intimal sarcoma. Two years after surgery, she died of multiple organ failure due to sepsis during chemotherapy for bone metastases.