Recurrent rupture of intercostal artery aneurysms in neurofibromatosis type 1

Vasculopathy associated with neurofibromatosis type 1 (NF-1) can cause a spontaneous hemothorax, which is an uncommon but life-threatening complication of the disease. We report a case of recurrent rupture of intercostal artery aneurysms in an NF-1 patient. A 40-year-old man with NF-1 suffered from a right spontaneous hemothorax. The bleeding source was not identified by dynamic contrast-enhanced computed tomography (CT), so he was initially treated by conservative therapy. However, repeated contrast CT revealed aneurysms of the right 10th intercostal artery. They were successfully occluded by transcatheter arterial embolization (TAE). Seven months afterward, he presented with sudden lower back pain and was diagnosed with a contralateral spontaneous hemothorax due to a ruptured aneurysm of the left 12th intercostal artery. TAE was successfully performed.