Abstract
Introduction: Primary malignant aortic tumors are rare and diagnosis can be difficult due to the variety of clinical manifestations. This malignant disease, which originates in the intima or medial layers of the aorta, presents a complex diagnostic and therapeutic dilemma. Due to their insidious growth and nonspecific symptoms, they are often diagnosed postmortem. Case Presentation: We present the case of a sarcoma of the descending part of thoracic aorta in a 69-year-old man. The initial symptoms were hypertension crisis, chest pain, shortness of breath, and swollen legs. A computed tomography scan of the chest and abdomen revealed an obstructive mass in the thoracic aorta. Treatment consisted of performing prosthesis of the thoracic aorta and removal of thrombi/tumor masses from the thoracoabdominal aorta and iliac artery on both sides, as well as chemotherapy. Conclusion: Aortic sarcoma should be recognized as a potential cause of a large thrombus in the aorta. Palliative procedures, including open aortic replacement, may also serve as alternative treatment options for aortic sarcoma.