[Saccular aneurysm of the superior vena cava]

Area of Science:

• Cardiovascular Surgery
• Thoracic Oncology
• Diagnostic Imaging

Background:

• Congenital aneurysms of the superior vena cava (SVC) are rare vascular malformations.
• Saccular aneurysms of the SVC are exceptionally uncommon, with few cases reported in medical literature.
• Mediastinal masses can present diagnostic challenges, necessitating advanced imaging and surgical exploration.

Observation:

• A 38-year-old female presented with a suspected mediastinal tumor.
• Computed tomography (CT) imaging revealed a deceptive appearance due to complete thrombosis within the aneurysmal sac.
• Diagnosis was definitively established during thoracotomy.

Findings:

• A saccular aneurysm of the superior vena cava was identified as the cause of the mediastinal abnormality.
• Complete thrombosis of the aneurysm significantly obscured its true nature on preoperative imaging.
• This case highlights the diagnostic difficulties associated with thrombosed SVC aneurysms.

Implications:

• Accurate diagnosis of rare SVC aneurysms is crucial for appropriate management.
• Thoracotomy may be required for definitive diagnosis and treatment of complex mediastinal vascular lesions.
• Increased awareness of SVC aneurysms, particularly saccular and thrombosed types, can improve diagnostic accuracy and patient outcomes.