Painful tumor of the neck as a result of a ruptured aneurysm of the aortic arch

Acute tumors of the neck are etiologically ambigous and the underlying diagnosis is difficult to confirm in the anatomically complex region. Here, we report on a rare case of a cervical tumor caused by a large ruptured aneurysm of the aorta.

The 99 y.o. female patient presented via the emergancy unit with acute hemoptysis and cervical swelling. A respiratory tract infection persisted for 2 weeks. Odyno- and dysphagia were reported during the latest few months. The patient was alert and oriented without dyspnea or stridor. The larynx was shifted to the left with a vocal chord paralysis on the right. No active bleeding, but some blood admixture to the saliva was found. There was a rigid tumor paramedian to the right at the level of the thyroid gland. The skin above the lesion was fixated. There was tenderness on palpation.

The initial echography indicated a lesion from the thyroid gland. The additional CT scan of the neck and thorax indicated a tracheal perforation, mediastinitis, tracheomalacy and a aneurysm of the aortic arch with a diameter of 6 cm.

Moreover, there was an emphysema of the mediastinum and right neck up to the level of the mandibule.

After completing diagnostics and consultation of the cardiac surgeons the patient was transfered to a palliative care unit due to the infaust prognosis.

Publication History

Publication Date:
18 April 2018 (online)