Aortic dissection in the setting of large uterine leiomyoma

Isolated abdominal aortic dissections are rare. They are often spontaneous, but can also occur secondary to iatrogenic interventions or trauma. The management of asymptomatic abdominal aortic dissections is primarily medical. Over time, chronic abdominal aortic dissections can lead to aneurysmal degeneration of the abdominal aorta. Herein, we describe a unique case of a large uterine mass and an isolated abdominal aortic dissection with aneurysmal degeneration. We hypothesize that the chronically enlarged uterus led to repeated shear stress on the abdominal aorta and iliac artery, contributing to aortic dissection and aneurysmal degeneration.