[Aneurysm of the aortic arch: presenting as mediastinal tumor]

We report the case of a 62-year-old woman who presented with severe abdominal pain. The routine chest x-ray showed an anterior mediastinal mass measuring approximately 10 cm in diameter. CT-Scan and angiography demonstrated an aneurysm of the aortic arch compromising the left pulmonary artery and main bronchus. An additional aneurysm of the abdominal aorta and right iliac artery was seen, which apparently led to the abdominal symptoms. Coronary angiography revealed coronary artery disease. The aortic arch aneurysm was treated by interposition of a vascular graft. Aorto-coronary bypass grafts were implanted. The abdominal aneurysm was resected in a staged approach after recovery from the first operation.