Ruptured pseudoaneurysm of the thoracic aorta mimicking lung cancer: A case report

Takahara, Yutaka; Nishiki, Kazuaki; Nakase, Keisuke; Mizuno, Shiro

doi:10.1111/1759-7714.13783

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…We could not differentiate ruptured aneurysm from cancer recurrence by unenhanced CT images for the initial assessment. There are a few case reports of thoracic aortic aneurysm that was misrecognized as lung cancer [1,2] while lung cancer was also misrecognized as aortic aneurysm [3]. In our case, local adhesion due to previous surgery seemed to fortunately prevent complete rupture of thoracic aneurysm although postoperative state led to a cognitive bias for the misdiagnosis.…”

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confidence: 65%

Thoracic aortic pseudoaneurysm mimicking recurrence of lung cancer

Kimura¹

2022

J Clin Images Med Case Rep

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A man in his late 70’s visited to a hospital with one day history of fever and cough. Eight years before, he underwent a left upper lobectomy due to stage IB lung cancer. He had taken follow-up Computed Tomography (CT) exams annually and no abnormality was detected 9 months earlier (Figure 1A and B). Laboratory data showed elevated C-reactive protein, 9.7 mg/dL and D-dimer, 2.5 μg/mL with normal white blood cell counts. A chest CT on a visit showed a mediastinal mass near the resected site of left upper lobe (Figure 1C and D) with slight ground- glass opacity around it. Local recurrence of lung cancer with mild pneumonia was suspected, then an oral antibiotic was administered. His fever was alleviated and contrast-enhanced CT was performed one week later for detailed examination, which revealed a ruptured pseudoaneurysm of thoracic aorta (Figure 2A and B). Semi-urgent total arch replacement was completely achieved although it was tough due to severe adhesion of surrounding tissue. He was discharged without any complications on the 30th postoperative day.

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confidence: 65%

Thoracic aortic pseudoaneurysm mimicking recurrence of lung cancer

Kimura¹

2022

J Clin Images Med Case Rep

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“…There are a few case reports of thoracic aortic aneurysm being misdiagnosed as lung cancer, and lung cancer being misdiagnosed as aortic aneurysm. [1][2][3] If a contrast-enhanced CT scan was not performed immediately after the mass was discovered in contact with the aorta, it should be considered.…”

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confidence: 99%

Right proximal sub-clavian artery pseudoaneurysm masquerading as right upperzone opacity of lung

Cheguri¹,

Kadam²,

Jain³

et al. 2023

Int J Res Med Sci

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Right proximal subclavian artery pseudoaneurysms are uncommon conditions with a relatively small number of recorded instances to date. Such cases might be challenging to diagnose since the patient may have symptoms that are similar to those of other illnesses, including lung cancer. The diagnosis is aided by imaging methods including contrast-enhanced computed tomography (CECT) chest and computed tomography angiography, as well as a high level of clinical suspicion. We present a rare case of a 23-year-old man with no history of lung disease or trauma, who had a complaints of change in voice, difficulty in swallowing and haemoptysis. Right-sided upper zone homogeneous opacity was seen on the chest X-ray. CECT revealed large, well-defined solid cystic areas that extended up to the posterosuperior aspect of the right upper thoracic region. Aneurysm rupture with active contrast leak. Pulmonary angiography revealed the presence of a pseudoaneurysm in the middle mediastinum on the right side, originating from the right proximal subclavian artery. The patient was operated on, and the right subclavian artery and innominate artery pseudoaneurysm were repaired. If subclavian artery pseudoaneurysms are large, they can cause compression symptoms. For compressive symptoms, open surgical resection and vascular reconstruction are required. In a patient with hemoptysis and opacities on chest imaging, arterial aneurysm should be considered as a differential diagnosis alongside lung mass. Before considering a biopsy from the lesion, further evaluation with CECT should be performed.

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Ruptured pseudoaneurysm of the thoracic aorta mimicking lung cancer: A case report

Cited by 2 publications

References 17 publications

Thoracic aortic pseudoaneurysm mimicking recurrence of lung cancer

Thoracic aortic pseudoaneurysm mimicking recurrence of lung cancer

Right proximal sub-clavian artery pseudoaneurysm masquerading as right upperzone opacity of lung

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