J Korean Med Sci.  2005 Aug;20(4):674-676. 10.3346/jkms.2005.20.4.674.

Intrathoracic Aneurysm of the Right Subclavian Artery Presenting with Hoarseness: A Case Report

• Bin HG
• Kim MS
• Kim SC
• Keun JB
• Lee JH
• Kim SS

• KMID: 1712753
• DOI: http://doi.org/10.3346/jkms.2005.20.4.674

Abstract

Intrathoracic segment of the subclavian artery is an unusual location for peripheral arterial aneurysms. They are normally caused by atherosclerosis, medial degeneration, trauma, and infection. We report a case of a patient with right subclavian artery aneurysm presenting with hoarseness. Chest radiograph demonstrated a superior mediastinal mass. Laryngoscopy showed a fixed right vocal cord. By chest computed tomography, magnetic resonance imaging, and angiography, preoperative diagnosis was established as a saccular aneurysm with afferent loop and efferent loop. Patient underwent complete resection of the aneurysm followed by endto-end anastomosis via median sternotomy. Postoperative pathology was consistent with an atherosclerotic aneurysm filled with thrombus. After surgical operation, hoarseness is still continued.

Keyword

Aneurysm; Hoarseness; Subclavian Artery

MeSH Terms

Aged
Aortic Aneurysm, Thoracic/complications/*pathology
Female
Hoarseness/etiology/*pathology
Humans
Magnetic Resonance Imaging/methods
Subclavian Artery/*pathology/radiography

Figure

• 

  Fig. 1 PA chest roentgenogram shows well-defined, paratracheal mass of about 7 cm in the upper zone of the right hemithorax.

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  Fig. 2 Contrast enhanced computed tomography (CT) demonstrates a 7 cm sized proximal right subclavian artery aneurysm and intraluminal yin-yang appearance due to thrombus.

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  Fig. 3 Reconstructed three-dimensional magnetic resonance imaging (MRI) demonstrated positional relationships between right subclavian artery aneurysm and surrounding vessel.

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  Fig. 4 Preoperative digital subtraction angiography of mass revealing an saccular aneurysm of right subclavian artery with afferent and efferent loop and intraluminal filling defects.

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  Fig. 5 (A) Microscopically, atheromatous plaque contains amorphous pink material with slit-like "cholesterol clefts" of lipid material and calcification. There is recent hemorrhage on right side (H&E stain, ×20). (B) At higher magnification, many foam cells and a cholesterol cleft are seen (H&E stain, ×200).

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