Clinics in diagnostic imaging (194). SVC aneurysm

Area of Science:

• Cardiology
• Radiology
• Thoracic Surgery

Background:

• Anterior mediastinal masses are a diverse group of pathologies requiring accurate diagnosis.
• Vascular anomalies, though uncommon, can mimic neoplastic or other mediastinal lesions.

Observation:

• A 68-year-old woman presented with significant unintentional weight loss and an incidental mediastinal opacity on chest radiography.
• Computed tomography revealed an anterior mediastinal mass with characteristic enhancement patterns suggestive of a vascular origin.

Findings:

• The imaging findings were consistent with an aneurysm of the superior vena cava, a rare cause of anterior mediastinal masses.
• The aneurysm demonstrated heterogeneous enhancement in the arterial phase with contrast pooling, followed by homogeneous enhancement in the venous phase.

Implications:

• This case emphasizes the need to include superior vena cava aneurysms in the differential diagnosis of anterior mediastinal masses.
• Accurate radiological characterization is crucial for appropriate management and to avoid misdiagnosis of malignancy.