Presentation
Cough and shortness of breath for a few days.
Patient Data
Age: 90
Gender: Male
From the case:
Left vertebral artery aneurysm
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Large left mediastinal mass with stent and peripheral calcification.
From the case:
Left vertebral artery aneurysm
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There is an aneurysm at the expected origin of the left vertebral artery. The aneurysm has extensive concentric mural thrombus and fills via a patent neck with a broad based attachment to the subclavian artery.
The left vertebral artery distal to the aneurysm does not opacify with contrast except in its distal portion where it fills retrograde from the basilar artery. Distally the subclavian artery is of normal caliber and opacifies normally.
Case Discussion
Vascular causes such as aneurysms should be recalled as a cause for mediastinal masses. The stent within the mass is a pretty big give away in this case.
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