Nose Naohiro, Kataoka Hiroumi, Hamada Masakatsu, Kosako Yukio, Matsuno Yasuji, Ishii Takahiro
Department of Thoracic Surgery, Shinyukuhashi Hospital, 1411 Ooazadoujyouji, Yukuhashi 824-0026, Japan.
Int J Surg Case Rep. 2012;3(12):605-7. doi: 10.1016/j.ijscr.2012.08.007. Epub 2012 Aug 24.
Saccular aortic arch aneurysms in unusual sites may be misdiagnosed as a neoplasm. We present the case of a rare saccular aortic arch aneurysm between trachea and esophagus that resembled a mediastinal neoplasm in the preoperative findings.
A 63-year-old male with an abnormal mediastinal shadow on chest X-ray was referred to the hospital. An axial plain computed tomogram of the chest revealed mediastinal soft tissue next to the right side of the aortic arch resembling a neoplasm originating from the gap between the trachea and the esophagus. The coronal view constructed by enhanced 64-row multi detector computed tomography revealed the soft tissue was an aneurysm arising from the inner side of the aortic arch. An aortic arch replacement was performed via a median sternotomy.
A thoracic aortic aneurysm sometimes behaves like a mediastinal neoplasm. The multiple cross-sectional image from multidetector computed tomography was useful for the correct diagnosis of such an aneurysm.
The possibility of an aneurysm should be considered whenever a mass in contact with the aortic wall is identified.
罕见部位的囊状主动脉弓动脉瘤可能被误诊为肿瘤。我们报告一例罕见的位于气管和食管之间的囊状主动脉弓动脉瘤病例，其术前表现类似纵隔肿瘤。
一名63岁男性因胸部X线显示纵隔阴影异常而被转诊至我院。胸部轴向平扫计算机断层扫描显示主动脉弓右侧旁的纵隔软组织，类似起源于气管和食管间隙的肿瘤。64排多层螺旋CT增强扫描构建的冠状位图像显示，该软组织是一个起源于主动脉弓内侧的动脉瘤。通过正中胸骨切开术进行了主动脉弓置换术。
胸主动脉瘤有时表现类似纵隔肿瘤。多排螺旋CT的多层横断面图像有助于此类动脉瘤的正确诊断。
当发现与主动脉壁接触的肿块时，应考虑动脉瘤的可能性。
