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335489

Misinterpretation of a giant idiopathic concealed right iliac artery aneurysm as infantile pelvic tumor imaged by non-angiographic computed tomography: a case report

Article

Last updated: 20 Dec 2024

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Abstract

Background
Idiopathic pediatric artery aneurysm is extremely rare and sometimes behaves like a pelvic neoplasm. As it is associated with a high mortality while ruptured, the accurate diagnosis is indispensable to avoid life-threatening complications. Angiographic imaging is the gold standard for diagnosis and treatment planning of the aneurysm. Due to the considerably higher radiation sensitivity of children, single portal venous-phase scanning of the abdominopelvic computed tomography (CT) is, however, reasonably utilized for the evaluation of a clinically palpable mass; the erroneous diagnosis of such aneurysm can be feasible.
Case presentation
A giant idiopathic concealed right iliac artery aneurysm in a 47-day-old girl presented with a palpable pelvic mass regardless of unidentifiable predisposing factors. Non-angiographic abdominopelvic CT was reappraised by the radiology consultant according to discordance between the mass characteristics on initial CT report and those on second-look sonography, revealing the concealed aneurysm instead of solid neoplasm as it originated from right internal iliac artery. The patient underwent an emergency laparotomy with successful proximal ligation of right internal iliac artery despite intraoperative aneurysmal rupture.
Conclusions
Typical CT features for the infantile iliac artery aneurysms may be overlooked, especially if the angiographic phase is omitted; thus, the imaging characteristics of the aneurysms are more difficult to appreciate and can mimic a pelvic neoplasm. Therefore, the identification of the origin of the mass should be more practical to achieve the precise diagnosis.

DOI

10.1186/s43159-023-00246-y

Keywords

Idiopathic aneurysm, Iliac aneurysm, congenital, Computed tomography, Case Report

Authors

First Name

Thipsumon

Last Name

Tangsiwong

MiddleName

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Affiliation

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Email

fonthipsumon@gmail.com

City

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Orcid

0000-0002-2318-2092

First Name

Tipsuda

Last Name

Tangsriwong

MiddleName

-

Affiliation

-

Email

-

City

-

Orcid

-

Volume

19

Article Issue

1

Related Issue

45427

Issue Date

2023-01-01

Receive Date

2023-03-15

Publish Date

2023-03-27

Print ISSN

1687-4137

Online ISSN

2090-5394

Link

https://apsj.journals.ekb.eg/article_335489.html

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https://apsj.journals.ekb.eg/service?article_code=335489

Order

335,489

Publication Type

Journal

Publication Title

Annals of Pediatric Surgery

Publication Link

https://apsj.journals.ekb.eg/

MainTitle

Misinterpretation of a giant idiopathic concealed right iliac artery aneurysm as infantile pelvic tumor imaged by non-angiographic computed tomography: a case report

Details

Type

Article

Created At

20 Dec 2024