Presentation
History of brain fogging for which the patient had CT examination (not shown) and an incidental finding was noted. Follow up MRA was recommended.
Patient Data
Large fusiform aneurysm of the superior vena cava and adjacent azygos vein.
Case Discussion
Among all the intrathoracic masses only 10% are accounted for by vascular lesions. There are only 27 reported cases of aneurysms arising from mediastinal systemic veins 1. Superior vena cava aneurysm is the most common vascular malformation among these. The first case was reported by Abbot in 1950 2.
Superior vena cava aneurysms are usually primary. Complications are rare; however, pulmonary embolism and contained rupture have been reported.
The complications are treated medically or surgically as required. Saccular aneurysms are managed surgically in view of the risk for thrombus formation and pulmonary embolism. As the fusiform variety has low risk potential, they are usually managed conservatively with follow-up imaging.