Ezzahi Manar, Bijbij Ayman, Akammar Amal, El Bouardi Nizar, Haloua Meriem, Lamrani Moulay Youssef Alaoui, Boubbou Meryem, Maaroufi Mustapha, Alami Badreeddine
Department of Radiology and Interventional Imaging, CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Fez, Morocco.
Radiol Case Rep. 2023 Jul 12;18(9):3317-3322. doi: 10.1016/j.radcr.2023.07.003. eCollection 2023 Sep.
Aortic coarctation is a congenital malformation that is relatively prevalent, occurring in approximately 5 out of every 1000 births. The narrowing typically happens at the aortic isthmus between the left subclavian artery and the arterial ligament. It is frequently associated with a bicuspid aortic valve. Generally, coarctation of the aorta is identified and treated during childhood or early adulthood. If left untreated, this condition can lead to a reduced life expectancy in individuals who have not received treatment. We present a case of a 52-year-old man who complained of chest pain, sputum, and hemoptysis persisting for approximately 2 years. Contrast-enhanced computed tomography (CT) scans revealed the presence of an anterior mediastinal mass, which was later confirmed to be a thymic carcinoma (on histological study). Additionally, an incidental finding of a thoracic aortic coarctation with a well-developed collateral circulation was observed. The discovery of aortic coarctation in adult patients as an incidental finding is rare and particularly uncommon in association with mediastinal or thoracic tumor pathology. Adult and elderly patients with uncorrected coarctation generally have a low survival rate, and the management strategies for such cases are controversial, especially when it is associated to other pathologies. Due to the complexity of therapeutic management and the limited literature available on postsurgical outcomes in these cases, making therapeutic decisions requires a multidisciplinary approach and personalized consideration for each individual case. This approach is necessary to evaluate the risk-benefit ratio and determine the most suitable therapeutic solution.
主动脉缩窄是一种相对常见的先天性畸形，每1000例出生中约有5例发生。狭窄通常发生在左锁骨下动脉和动脉韧带之间的主动脉峡部。它常与二叶式主动脉瓣相关。一般来说，主动脉缩窄在儿童期或成年早期被识别和治疗。如果不治疗，这种情况会导致未接受治疗的个体预期寿命缩短。我们报告一例52岁男性，主诉胸痛、咳痰和咯血持续约2年。增强计算机断层扫描（CT）显示前纵隔有肿块，后来经组织学研究证实为胸腺癌。此外，偶然发现胸主动脉缩窄并伴有发育良好的侧支循环。在成年患者中偶然发现主动脉缩窄是罕见的，与纵隔或胸段肿瘤病理相关的情况尤其少见。未矫正的主动脉缩窄的成年和老年患者一般生存率较低，此类病例的治疗策略存在争议，尤其是当它与其他病理情况相关时。由于治疗管理的复杂性以及这些病例术后结果的文献有限，做出治疗决策需要多学科方法并对每个病例进行个性化考虑。这种方法对于评估风险效益比和确定最合适的治疗方案是必要的。
