Granulomatosis With Polyangiitis Involving the Ascending Aorta

A 58-year-old man visited the emergency department with vague anterior chest discomfort. From the computed tomographic findings, our initial suspicion was intramural hematoma in the ascending aorta. After a comprehensive discussion with relevant departments, emergent operation was planned. Intrapericardial space, however, was severely adhered, suggesting chronic inflammation. Biopsies were performed, and additional surgical procedures were discontinued. The patient was finally diagnosed as having granulomatosis with polyangiitis. Careful approach with high-degreed suspicion for granulomatosis with polyangiitis, although rare, is required when preoperative findings are similar to the present case.