Huge Femoral Artery Pseudoaneurysm
A 94-year-old woman presented to our clinic with a painless, swollen right thigh (Figure, A). Gunshot injury of the right lower extremity during World War II was reported. Progressive swelling of right thigh was noted during the past 10 years. Aspiration had been performed 3 times previously and revealed sanguineous fluid. The mass was firm in consistency. No pulsation was detected. Doppler ultrasound showed no flow signal inside. Fluoroscopy showed asymmetric soft tissue shadow in both lower extremities (Figure, B). Computed tomography showed a heavily calcified, dilated femoral artery (Figure, C) and multiple lobes of well-encapsulated, cystic masses (Figure, D). The total tumor was excised under proximal control of the common femoral artery. The femoral artery was reconstructed with the ipsilateral saphenous vein. The gross specimen showed a pseudoaneurysm with an organized thrombus measuring 22×18×14 cm (Figure, E). Microscopically, the sections showed atherosclerosis. The patient had a smooth recovery.
Figure. A, Bulging mass in the right thigh with engorged overlying superficial veins. B, Fluoroscopy shows asymmetric soft tissue density over bilateral thighs. C, Reconstructed, contrast-enhanced computed tomography angiography shows heavily calcified and dilated right superficial femoral artery with no extravasation. D, Axial cut shows multiple, well-encapsulated, cystic masses. E, The final specimen measured 22×18×14 cm.
Disclosures
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