Thoracic aortic aneurysm is one of the late and uncommon presentations of syphilis. If the aneurysm is large it causes symptoms suggesting mass effect. Syphilis being a common disease worldwide has recently re-emerged. Early syphilis if left untreated can lead to a significant morbidity. We reported a case of 44 years old man who was incidentally detected to have syphilitic thoracic aortic aneurysm with features of SVC compression.
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