Evaluating endoleaks in the dermatology office

We report the case of a 69-year-old woman who was referred to our dermatology office by her primary care physician for evaluation of a subcutaneous mass overlying the right mid sternum, which was a suspected lipoma. The mass was asymptomatic and had been present for approximately 2 weeks. The patient had undergone an aortic valve replacement approximately 2.5 years prior for treatment of an ascending aortic aneurysm. Physical examination revealed a mass located at the site of the thoracotomy scar. She was referred for an ultrasound and computed tomography angiography. Results of computed tomography angiography were consistent with a type V endoleak, and the patient was then referred to a cardiothoracic surgeon for treatment. Our case represents an unusual entity for presentation at a dermatology clinic, but endoleaks can have dire consequences if they are not recognized and treated appropriately. Dermatologists should be aware of the clinical presentation of endoleaks and this article explains the causes.