Incidental thoracic aortic pseudoaneurysms and pulmonary squamous cell carcinoma

Case contributed by Yaïr Glick
Diagnosis almost certain

Presentation

Shoulder trauma.

Patient Data

Age: 85 years

No visible shoulder fracture.
Small opacity with lobulated borders in left lung midzone, suspicious for carcinoma.
Stent in LAD artery.
Calcified thoracic aorta with irregular contour.

No evidence of fracture.

Lobulated, spiculated subpleural mass in the left upper lobe (LUL).
Calcified RCA and LCx, stented LAD.
Left ventricular myocardial calcification.
Heavily calcified aorta. Multiple outpouchings from the aortic wall, the largest at the isthmus.

Case Discussion

History notable for 120 pack years of smoking, ischemic heart disease, severe peripheral vascular disease, and COPD.

Shoulder X-rays obtained to rule out fracture. CT shoulder done without waiting for an official reading, to search for an occult fracture.

Incidental LUL mass highly suspicious for carcinoma. Pathology report: squamous cell carcinoma, moderately differentiated, keratinizing.

Incidental aortic outpouchings, most probably pseudoaneurysmsMycotic aneurysms can be ruled out, as no history of infection.

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