Unexpected Intraoperative Finding of Azygos Vein Aneurysm Mimicking a Metastatic Lymph Node

Obeso, Andrés; Souilamas, Rédha

doi:10.1016/j.arbres.2017.07.017

Cited by 6 publications

(2 citation statements)

References 2 publications

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“…In a previous case of AVA in a patient with esophageal cancer, this made the final diagnosis much more difficult to be established and it was discovered during exploratory thoracoscopy (30). Another association of AVA with pulmonary cancer was presented in a patient, who was diagnosed using transesophageal echography, which helped differentiate between an aneurysm and paratracheal mediastinal lymph nodes (31,32).…”

Section: Discussionmentioning

confidence: 99%

Azygos Vein Aneurysm Mimicking a Mediastinal Mass

Savu

Melinte

Bălescu³

et al. 2020

In Vivo

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Background/Aim: Azygos vein aneurysm (AVA) is a rare thoracic pathological entity that mimics a posterior mediastinal mass as well as a right paratracheal mass. Usually asymptomatic, AVA is often accidentally discovered during routine chest x-rays; however, depending on the aneurysm size and complications, some symptoms may be present. The aim of this paper is to report a case of idiopathic AVA and to discuss its aetiology, embryonic origin, symptoms, complications, diagnostic methods and treatments. Case Report: A 74-yearold female was investigated for diffuse thoracic pain and submitted to standard chest x-ray, which identified a right paratracheal, well-defined, homogenous opacity, considered to be part of the mediastinal shadow. The patient was further submitted to thoracic computed tomography, which confirmed the presence of a tumoral mass at the level of the right paratracheal area. The patient was submitted to surgery and the tumoral mass was resected; however, the tumor proved to be a completely thrombosed aneurism of the azygos vein arch. Conclusion: AVA is a rare pathology that must be taken into consideration during the differential diagnosis of right posterosuperior mediastinal masses.

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Section: Discussionmentioning

confidence: 99%

Azygos Vein Aneurysm Mimicking a Mediastinal Mass

Savu

Melinte

Bălescu³

et al. 2020

In Vivo

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“…In view of the various clinical presentation, MHA is often confused with fibromas, paragangliomas, lymphomas, and bronchial cysts [ 9 , 10 , 11 , 12 ]. Additionally, any suspicions of posterior mediastinal tumors with malignant biological behavior should be evaluated by diagnostic investigations, such as enhanced CT, magnetic resonance imaging, FDG-PET/CT, and digital subtraction angiography [ 13 , 14 , 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Refractory Chylothorax Secondary to Sizeable Azygos Vein Hemangioma: Tailored Multimodal Treatment of a Challenging Case Report

et al. 2022

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Background: Mediastinal hemangiomas are rare, and their etiology remains unclear. Most patients affected have no pathognomonic clinical symptoms, and the diagnosis is often incidental. Due to the paucity of the available literature regarding the management of this disease, the choice and timing of treatment remains controversial. Case presentation: Herein, we report the case of a hemangioma of the azygos vein arch in a 66-year-old woman who presented with dyspnea, chest discomfort, dysphagia, and weight loss. A simultaneous right chylothorax refractory to conservative management was found. A CT-guided biopsy of the mass was performed, and it confirmed the vascular nature of the lesion. Therefore, the patient underwent an angiography followed by endo-vascular embolization. Three days later, thoracoscopic surgical resection of the mass and the repair of the chyle leakage were performed safely. The patient was discharged uneventfully on postoperative day seven, with complete resolution of all the presenting symptoms. Conclusions: Treatment of symptomatic mediastinal hemangiomas could be mandatory, but a thorough multidisciplinary approach to these rare malformations is essential. Despite the risk of intraoperative bleeding, selective endovascular embolization followed by thoracoscopic surgery allowed for a complete and safe resection with a good outcome.

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Thoracoscopic approach to the resection of idiopathic azygos vein aneurysm: a case report

Ling

Rong

Fang

et al. 2022

J Cardiothorac Surg

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Background Azygos vein aneurysm (AVA) is a rare thoracic pathological entity that mimics a posterior mediastinal mass. However, the pathogenesis of primary azygos vein aneurysms is not clear and its pathology is still being discussed. Some of the AVA are asymptomatic and usually discovered accidentally by routine physical examination. Case presentation We report the case of a 37-year-old woman who had an azygos vein arch aneurysm with no obvious clinical symptoms. With the analysis of clinical features of the case and AVA morphological characteristics, the AVA was found by a chest computed tomography. Then, enhanced chest computed tomography showed a soft-tissue mass (4.9 × 3.7 × 3.2 cm) in the right posterior mediastinum, which was connected to the superior vena cava and significantly enhanced with contrast agent stratification. The density of the tumor in the delayed stage was the same as that in the azygos vein. The patient underwent video-assisted thoracoscopic surgery. Histopathological evaluation of the surgical biopsy specimen proved to be a completely thrombosed aneurism of the azygos vein arch. Conclusions AVA is a rare pathology that must be taken into consideration during the differential diagnosis of right posterior mediastinal masses. Thoracoscopic surgery is one of the most preferred treatment options for azygos vein aneurysm.

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Unexpected Intraoperative Finding of Azygos Vein Aneurysm Mimicking a Metastatic Lymph Node

Cited by 6 publications

References 2 publications

Azygos Vein Aneurysm Mimicking a Mediastinal Mass

Azygos Vein Aneurysm Mimicking a Mediastinal Mass

Refractory Chylothorax Secondary to Sizeable Azygos Vein Hemangioma: Tailored Multimodal Treatment of a Challenging Case Report

Thoracoscopic approach to the resection of idiopathic azygos vein aneurysm: a case report

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