Korean J Radiol.  2014 Oct;15(5):637-640. 10.3348/kjr.2014.15.5.637.

Massive Thoracoabdominal Aortic Thrombosis in a Patient with Iatrogenic Cushing Syndrome

• Kim DH
• Choi DH
• Lee YM
• Kang JT
• Chae SS
• Kim BB
• Ki YJ
• Kim JH
• Chung JW
• Koh YY

• KMID: 1734949
• DOI: http://doi.org/10.3348/kjr.2014.15.5.637

Abstract

Massive thoracoabdominal aortic thrombosis is a rare finding in patients with iatrogenic Cushing syndrome in the absence of any coagulation abnormality. It frequently represents an urgent surgical situation. We report the case of an 82-year-old woman with massive aortic thrombosis secondary to iatrogenic Cushing syndrome. A follow-up computed tomography scan showed a decreased amount of thrombus in the aorta after anticoagulation therapy alone.

Keyword

Computed tomography; Echocardiography; Iatrogenic Cushing syndrome; Massive thoracoabdominal aortic thrombosis

MeSH Terms

Aged, 80 and over
Anticoagulants/therapeutic use
Aorta, Abdominal/ultrasonography
Cushing Syndrome/*complications/*diagnosis
Electrocardiography
Female
Humans
Iatrogenic Disease
Thrombosis/*diagnosis/drug therapy/*etiology
Tomography, X-Ray Computed
Treatment Outcome
Anticoagulants

Figure

• 

  Fig. 1 Massive thoracoabdominal aortic thrombosis in 82-year-old woman with iatrogenic Cushing syndrome. A. Suprasternal notch view of transthoracic echocardiography showing large thrombi (arrows) in aortic arch (AA) with proximal floating end (dashed arrow). B. Aortic computed tomography (CT) scan with curved multiplanar reformation showing extensive thrombi from distal ascending thoracic aorta to proximal descending thoracic aorta and distal abdominal aorta (arrows). C. Coronary CT angiography with curved multiplanar reformation demonstrating suspicious tight stenosis with no definite plaque in mid left anterior descending coronary artery (arrow). D. Follow-up aortic CT scan with curved multiplanar reformation showing slightly decreased amount of thrombus in thoracic aorta and abdominal aorta (arrows). LV = left ventricle. E. Follow-up suprasternal notch transthoracic echocardiography view showing amount of thrombus in aortic arch (AA) had decreased (arrows) and proximal floating end of thrombus had disappeared (dashed arrow).

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