Background: Emergence of a malignant tumor at the site of an operation is a rare event and most often arises in association with retained foreign material.
Case description: We describe a patient who 1 year after a left carotid endarterectomy for typical atheromatous lesions presented with several transient ischemic attacks with stepwise worsening of the deficit and rapid death. A few weeks before, a tumor of the neck had appeared at the site of the previous endarterectomy. At postmortem examination, we found a malignant histiocytofibroma occluding the left carotid artery, with several recent ischemic foci in the corresponding cerebral hemisphere without metastasis or tumor emboli.
Conclusions: This observation is unusual owing to the histological type of the neoplasm and to the circumstance of emergence of the neoplasm.