Multifocal aortic aneurysms

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain


Work up for pulsatile abdominal mass on physical exam.

Patient Data

Age: 75 years
Gender: Male

Fusiform aneurysmal dilatation of the thoracic aorta is present, particularly at the arch and up to 75 mm, accompanied by mural calcifications and thrombosis with a maximum thickness of 28 mm. Aortic arch branches are intact, and there are no signs of a leak, rupture or aortobronchial and aorto-esophageal fistula.

In addition, fusiform aneurysmal dilatation of the infrarenal abdominal aorta is observed up to 60 mm, accompanied by mural thrombosis with a maximum thickness of 15 mm and some mural calcificatios. Both renal arteries are intact. No signs of rupture or aortocaval and aortoenteric fistula.

A few subcentimeter simple cortical cysts are seen in the kidneys.

The prostate gland is enlarged. 

Case Discussion

Thoracic aortic aneurysms are relatively uncommon compared to abdominal aortic aneurysms.
On the other hand, an aortic arch aneurysm is a less common form of thoracic aortic aneurysm and may account for around 10% of such aneurysms.

When reporting an aortic aneurysm, whether abdominal or thoracic, it is necessary to mention the shape, size, exact location and associated complications.
For more details, see: reporting tips for aortic aneurysms

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