Kuy SreyRam, Dua Anahita, Desai Sapan S, Baraniewski Henryk, Lee Cheong J
1Medical College of Wisconsin, Milwaukee, WI.
Perspect Vasc Surg Endovasc Ther. 2013 Dec;25(3-4):53-6. doi: 10.1177/1531003513512870. Epub 2013 Dec 17.
Mycotic aneurysms resulting from intravesical bacillus Calmette-Guérin (BCG) treatment are exceptionally rare. We report on the case of a 73-year-old man who underwent intravesical therapy of BCG for bladder carcinoma and developed a right neck mass. A carotid pseudoaneurysm within a fibrotic mass was noted on surgical exploration. Radical resection was performed followed by a polytetrafluoroethylene interposition graft. Final pathology revealed necrotizing granulomas and multinucleated giant cells concerning for tuberculoma. Intravesicular BCG immunotherapy is an accepted treatment for patients with urothelial carcinoma. Carotid aneurysms are exceptionally rare in this setting and should prompt evaluation for systemic tuberculoid dissemination.
膀胱内灌注卡介苗（BCG）治疗导致的霉菌性动脉瘤极为罕见。我们报告一例73岁男性患者，其因膀胱癌接受膀胱内卡介苗治疗后出现右侧颈部肿块。手术探查发现纤维化肿块内有一个颈动脉假性动脉瘤。进行了根治性切除，随后置入聚四氟乙烯移植血管。最终病理显示坏死性肉芽肿和多核巨细胞，提示为结核瘤。膀胱内卡介苗免疫治疗是尿路上皮癌患者公认的治疗方法。在这种情况下，颈动脉动脉瘤极为罕见，应促使对全身性结核样播散进行评估。
