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Massive fusiform superior vena cava aneurysm in a 47-year-old complicated by pulmonary embolism: A case report and review of literature

  • Harit Kapoor
    Correspondence
    Corresponding author.
    Affiliations
    Department of Radiology, University of Kentucky Chandler Medical Center, 800 Rose Street, Lexington, KY 40536, USA
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  • Author Footnotes
    1 Present address: Junior Resident, Imaging Associates at National Heart Institute, New Delhi, India.
    Vaibhav Gulati
    Footnotes
    1 Present address: Junior Resident, Imaging Associates at National Heart Institute, New Delhi, India.
    Affiliations
    Maulana Azad Medical College and Associated Hospitals, Bahadur Shah Zafar Marg, New Delhi 110002, India
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  • Barbara Pawley
    Affiliations
    Division of Emergency, Radiology, Department of Radiology, University of Kentucky Chandler Medical Center, 800 Rose St., HX315E Lexington, KY, USA
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  • James T. Lee
    Affiliations
    Division of Emergency and Abdominal Radiology, Department of Radiology, University of Kentucky Chandler Medical Center, 800 Rose St., HX315E Lexington, KY, USA
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  • Author Footnotes
    1 Present address: Junior Resident, Imaging Associates at National Heart Institute, New Delhi, India.

      Highlights

      • Superior vena caval aneurysms (SVCA) are rare true aneurysms.
      • SVCA diagnosis requires (i) a dilated SVC segment (Diameter > Aorta), & (ii) normal caliber both cranial and caudal to it.
      • Fusiform SVCAs are more common, developmental in origin and less sinister in contrast to Saccular SVCA.
      • Distal stricture and constrictive pericarditis are important imaging differentials for Fusiform SVCAs.
      • Unlike Saccular SVCAs, thromboembolism is rarely seen with fusiform SVCAs; and often successfully managed non-operatively.

      Abstract

      Superior vena cava (SVC) aneurysms are a rare occurrence. Given the rarity of SVC aneurysms and their propensity to be overlooked or misinterpreted on imaging, it is essential to be familiar with their appearance for accurate diagnosis, and to minimize thromboembolic risk, complications from rupture and mass effect. This report of a case of a massive fusiform SVC aneurysm that presented with pulmonary thrombo-embolism highlights the nuances of making an imaging diagnosis of SVC aneurysm and reviews the reported cases of fusiform SVC aneurysms that were diagnosed beyond childhood.

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      References

        • Sharma R.
        • Ravi M.
        • Unni T.G.
        Primary fusiform superior vena cava aneurysm.
        Cardiol Res. 2017; 8: 176-178https://doi.org/10.14740/cr570w
        • Janczak D.
        • Skiba J.
        • Gemel M.
        • Mak M.
        • Ziomek A.
        • Malinowski M.
        • Dorobisz T.
        • Lesniak M.
        • Janczak D.
        • Chabowski M.
        Giant saccular superior vena cava aneurysm-a rare and difficult clinical case.
        J Thorac Dis. 2016; 8: E247-E249https://doi.org/10.21037/jtd.2016.02.20
        • Sonavane S.K.
        • Milner D.M.
        • Singh S.P.
        • Abdel Aal A.K.
        • Shahir K.S.
        • Chaturvedi A.
        Comprehensive imaging review of the superior vena cava.
        Radiographics. 2015; 35: 1873-1892https://doi.org/10.1148/rg.2015150056
        • Taira A.
        • Akita H.
        Ruptured venous aneurysm of the persistent left superior vena cava.
        Angiology. 1981; 32: 656-659https://doi.org/10.1177/000331978103200912
        • Lin F.Y.
        • Devereux R.B.
        • Roman M.J.
        • Meng J.
        • Jow V.M.
        • Simprini L.
        • Jacobs A.
        • Weinsaft J.W.
        • Shaw L.J.
        • Berman D.S.
        • Callister T.Q.
        • Min J.K.
        The right sided great vessels by cardiac multidetector computed tomography: normative reference values among healthy adults free of cardiopulmonary disease, hypertension, and obesity.
        Acad Radiol. 2009; 16: 981-987https://doi.org/10.1016/j.acra.2009.02.013
        • Moncada R.
        • Demos T.C.
        • Marsan R.
        • Churchill R.J.
        • Reynes C.
        • Love L.
        CT diagnosis of idiopathic aneurysms of the thoracic systemic veins.
        J Comput Assist Tomogr. 1985; 9: 305-309https://doi.org/10.1097/00004728-198503000-00014
        • Gabriele A.R.
        • North L.
        • Pircher F.J.
        • Boushy S.F.
        Aneurysmal dilatation of the superior vena cava.
        J Nucl Med. 1972; 13: 227-229
        • Pasic M.
        • Schöpke W.
        • Vogt P.
        • von Segesser L.
        • Schneider J.
        • Turina M.
        Aneurysm of the superior mediastinal veins.
        J Vasc Surg. 1995; 21: 505-509https://doi.org/10.1016/S0741-5214(95)70294-6
        • Gaucher L.
        • Dezile G.
        • Roullier A.
        • Bouvier B.
        • Aloin M.
        • Delvert J.C.
        • Belda G.
        • Vandooren M.
        Saccular aneurysm of the superior vena cava.
        Rev Mal Respir. 1988; 5: 637-639
        • Patel A.
        • Cobb R.
        • Rivera V.
        • Simpson S.
        Untreated superior vena cava aneurysm: radiological significance and review of the literature.
        Case Rep Radiol. 2016; 2016: 1-3https://doi.org/10.1155/2016/6960757
        • Abbott O.A.
        Congenital aneurysm of superior vena cava; report of one case with operative correction.
        Ann Surg. 1950; 131 (illust): 259-263https://doi.org/10.1097/00000658-195002000-00013
        • Gallucci V.
        • Sanger P.W.
        • Robicsek F.
        • Daugherty H.K.
        Aneurysm of the superior caval vein.
        Vasc Surg. 1967; 1: 158-161https://doi.org/10.1177/153857446700100303
        • Ream C.R.
        • Giardina A.
        Congenital superior vena cava aneurysm with complications caused by infectious mononucleosis.
        Chest. 1972; 62: 755-757https://doi.org/10.1378/chest.62.6.755
        • Farr J.E.
        • Anderson W.T.
        • Brundage B.H.
        Congenital aneurysm of the superior vena cava.
        Chest. 1974; 65: 566-568https://doi.org/10.1378/chest.65.5.566
        • Polansky S.
        • Gooding C.A.
        • Potter B.
        Idiopathic dilatation of the superior vena cava (IDSVC).
        Pediatr Radiol. 1974; 2: 167-173https://doi.org/10.1007/BF00972729
        • Bell M.J.
        • Gutierrez J.R.
        • DuBois J.J.
        Aneurysm of the superior vena cava.
        Radiology. 1970; 95: 317-318https://doi.org/10.1148/95.2.317
        • Koga S.
        • Ikeda S.
        • Sanuki Y.
        • et al.
        A case of asymptomatic fusiform aneurysm of the superior vena cava detected by magnetic resonance imaging.
        Int J Cardiol. 2006; 113: e39-e41https://doi.org/10.1016/j.ijcard.2006.04.009
        • Nakajima Y.
        • Minami T.
        • Ishigaki H.
        • Sakai E.
        • Takahashi R.
        • Yokoi T.
        • Kuribayashi K.
        • Kijima T.
        A superior vena cava aneurysm discovered by chance at regular physical examination.
        Respir Investig. 2020; 58: 291-294https://doi.org/10.1016/j.resinv.2019.12.002