Diagnosis of primary tumors of the aorta is difficult. A patient who had a primary intimal sarcoma of the aorta with metastasis presented with obstructive symptoms and computed tomography showed a thrombus-like mass in the aorta. However, transesophageal echocardiography revealed an inhomogeneous and echo-dense mass with an outer membrane, unlike a thrombus, and suggestive of a primary aortic tumor. Pathologic examination of specimens from exploration and autopsy revealed a primary intimal sarcoma.
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