Traumatic false aneurysm of the common carotid artery presenting as a mediastinal mass: a case report

A 42-year-old man came to another institution with chest pain and a cough and was found to have a 15 cm mass on the left side of his chest. Carcinoma was suspected but not proved, and a course of chemotherapy was administered. Two years later he was referred to Duke University Medical Center after he experienced a thromboembolic event in his left upper extremity. A CT scan and angiogram of the chest showed a large false aneurysm located 5 cm from the origin of the left common carotid artery and filling the anterior mediastinum. Additional history was obtained of multiple stab wounds to the left side of the chest 7 years before admission. The aneurysm was treated with sequential saphenous vein bypass grafting of right common carotid to left common carotid to left subclavian artery, followed by aneurysm thrombosis induced with wire coils. The differential diagnosis of a chest mass should include aneurysms of the great vessels.