We report here on a long-surviving patient with a vascular leiomyosarcoma arising in the right common carotid artery, and some possible reasons for the long-term survival. The patient was a 40-year-old woman who was diagnosed with a right common carotid aneurysm and underwent aneurysmectomy with graft replacement. Two years and nine months after her surgery, she developed a cerebral infarction and left hemiparesis due to graft occlusion, but later achieved functional recovery through physical rehabilitation. She has been alive for 20 years since her surgery.
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