Intrathoracic Aneurysm of the Right Subclavian Artery Presenting with Hoarseness: A Case Report

Abstract

Intrathoracic segment of the subclavian artery is an unusual location for peripheral arterial aneurysms. They are normally caused by atherosclerosis, medial degeneration, trauma, and infection. We report a case of a patient with right subclavian artery aneurysm presenting with hoarseness. Chest radiograph demonstrated a superior mediastinal mass. Laryngoscopy showed a fixed right vocal cord. By chest computed tomography, magnetic resonance imaging, and angiography, preoperative diagnosis was established as a saccular aneurysm with afferent loop and efferent loop. Patient underwent complete resection of the aneurysm followed by end-to-end anastomosis via median sternotomy. Postoperative pathology was consistent with an atherosclerotic aneurysm filled with thrombus. After surgical operation, hoarseness is still continued.

An Atypical Cause of Shoulder Pain

“…These aneurysms are classified into two groups according to their etiologies, presentations, and therapeutic strategies: a) intrathoracic and b) extrathoracic. Those aneurysms that affect the intrathoracic portion of the subclavian artery develop mainly due to atherosclerosis, while those affecting the extrathoracic portion of the artery are usually due to trauma and thoracic outlet syndrome (5,7). In a very small portion of aneurysms, the etiologic factor can not be identified.…”

“…Subclavian artery aneurysms are usually asymptomatic pathologies. If a symptom is actually present, the most frequently encountered ones are upper chest and shoulder pain (6)(7)(8)10). Due to the closeness of the subclavian artery to the brachial plexus, an aneurysm arising from this artery may lead to motor and sensory symptomatology due to the impingement of the brachial plexus by the aneurysm (11).…”

“…Subclavian aneurysms are seen rather rarely; they make only 1% of all peripheral arterial aneurysms (7,8). These aneurysms are classified into two groups according to their etiologies, presentations, and therapeutic strategies: a) intrathoracic and b) extrathoracic.…”

Oropharyngeal Dysphagia: Neurogenic Etiology and Manifestation

“…Vocal cord Palsy following Cardiac surgery can result either due to intubation trauma or a direct manipulation and retraction procedure during the surgery. CC syndrome (cardio-vocal syndrome) which was first described by Ortner is characterized by hoarseness caused by compression of the left recurrent laryngeal nerve due to cardio vascular diseases like enlarged hypertensive pulmonary artery, cardiomegaly, aortic arch aneurysm, right subclavian aneurysm, ductus arteriosus aneurysm, or an enlarged left atrium which will compress the left recurrent laryngeal nerve [6][7][8][9][10][11][12][13].Flexible endoscopic examination showed immobility of the left side vocal cord in 28 of our patients and right side palsy in two of our patients. All the patients had hoarse voice.…”

A giant intrathoracic right subclavian artery aneurysm: a case report

“…[2] While the aneurysms of extrathoracic subclavian artery are mostly related to thoracic outlet syndrome or to previous injuries (iatrogenic), intrathoracic aneurysms are mainly due to atherosclerosis or less often seen with cystic medial degeneration, Ehler Danlos syndrome, Marfan's syndrome, giant cell arteritis, Takayasu's arteritis, infection, or injuries. [5,7] Herein, we discuss the surgical management of a young and non-atherosclerotic, vasculopathy in a case with a giant intrathoracic right subclavian artery aneurysm, as a rare pathological cause of intrathoracic subclavian aneurysms.…”