Authors confirm that there is no conflict of interest amongst them and the submitted manuscript is not under simultaneous RG7420 clinical trial consideration by any other publication. Patient described in the
case report is not alive at the time of submission. “
“Aneurysm and pseudoaneurysm of brachiocephalic artery are extremely rare conditions. Traumatic injuries can be the cause of it. The symptoms are usually nonspecific. The disease must be timely and properly diagnosed and treated in order to avoid the fatal end. 58 year-old male admitted to the Hospital of Lithuanian University of Health Sciences due to suspicion of mediastinal tumor for diagnostic endobronchial ultrasound procedure (EBUS) in July of 2010. Mediastinal tumor of 3.8 × 3.5 cm was found during chest CT scan one year before in June of 2009. Mediastinoscopy was suggested for diagnosis but not completed due to the cardiovascular problems (low ejection fraction of the left ventricle – 10%). The patient has been suffering from dilative cardiomyophathy and chronic atrial
fibrillation and has been treated with warfarin for three years. The patient used to work as sport trainer, had several chest traumas and surgery due to punctured wound of chest wall 30 years ago. The status of patient gradually deteriorated click here during one year before admission. The main patient’s complain was progressive dyspnea. Objective investigation revealed no major
findings: normal breath sounds, heart rate – 96 bpm, blood pressure – 120/80 mmHg. Chest CT scan in July 2010 showed the mediastinal tumor of the same size. During bronchoscopy at the time of admission smooth intratracheal nodule of 5 mm was found (Fig. 1). Superficial biopsy of polypoid nodule was performed with subsequent answer Morin Hydrate – normal airway mucosa. EBUS procedure was done. No clear lymph node structure or blood flow was detected. Although preliminary diagnosis was mediastinal tumor, the vascular malformation couldn’t be ruled out. One month later massive hemoptysis started. Urgent bronchoscopy revealed large right-sided mass and intratracheal wall dislocation due to the possible mediastinal tumor in the same location as the polyp in the first image (Fig. 2). Repeated chest CT scan (Fig. 3a–c) on August 2010 showed increasing tumor of size 4.0 × 3.2 × 4.0 cm in the mediastinum and pseudoaneurysm of brachiocephalic artery was suspected. The diagnosis was later confirmed by aortography (Fig. 4). The patient underwent successful aneurysmectomy. Aneurysm of brachiocephalic artery is a rare disease and could be caused by variety of diseases.1 and 4 Pseudoaneurysm of brachiocephalic artery is much more rare condition and traumatic injuries are the most frequent cause of this pathology.