PMC6236957_01
a Coronal gadolinium-enhanced T1-weighted image with fat saturation shows a posterolateral muscular mass of the left thigh with both necrotic and enhanced portions (white star); Saccular aneurysm of the descendant thoracic aorta (white head arrows): arterial phase CT scan of the aneurysm with axial view (b), coronal reconstruction (c) and 3D reconstruction (d). e PET-CT image fusion shows FDG uptake (white arrows) around the aneurysm. f Coronal maximum intensity projection (MIP) reconstruction of postoperative CT shows the endoprosthesis (transparent head arrows) and the excluded aneurysmal cavity (transparent arrow)
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Fig1
MRI of her left thigh showed a posterolateral muscular mass measuring five centimeters, with both necrotic and enhanced portions (Fig. 1a). A thoracoabdominal CT scan was performed for tumor staging and found a 35-mm saccular aneurysm of the descending thoracic aorta (Fig. 1b-d). FDG uptake around the aneurysm, which could be attributed to an infectious or tumorous process (Fig. 1e). Follow-up CT scans showed quick growth of the aneurysm from 35 to 49 mm. The patient was then transferred for endovascular aortic repair with an endoprosthesis (Fig. 1f) measuring 28 x 164 mm (Relay NBS  Bolton Medical).
Follow-up CT scans shows rapid progression of the lateral aortic metastasis (white head arrows) near the endoprosthesis (white arrows). a Initial postoperative CT scan shows a non-enhancing lateral aortic lesion which is difficult to differentiate from an excluded aneurysmal cavity. b One month later CT scan shows an important tumor's size increase with a minimal peripheral enhancement (b). c Six months later, CT scan shows an important tumor progression
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Fig2
Follow up CT scans (Fig. 2a-c) showed the appearance of a suspicious lesion near the excluded aneurysmal cavity with contrast-enhanced portions (Fig. 3a, b).
CT scan and MRI performed 6 months after endoprosthesis placement show a large lateral aortic tumor mass (white stars) with a progressive contrast enhancement (white arrows). CT scan shows a minimal contrast enhancement on portal phase (a) and an important one on delayed phase (b). Axial non-contrast (c) and gadolinium-enhanced T1-weighted images with fat saturation on arterial phase (d), portal phase (e) and delayed phase (f) show also a progressive tumor enhancement
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Fig3
Aortic MRI and contrast-enhanced ultrasound confirmed the presence of tumor tissue instead of thrombotic material within the aortic aneurysm sac (Fig. 3c-f).