A 76-year-old man was admitted to the hospital because of a right pulsatile, palpable, and asymptomatic axillary mass, which was increasing its volume in last 5 or 6 years. There was no known previous history of axillary infection, trauma, nor crutch use. No other pulsatile mass was found on physical examination. Ultrasonographic examination and an angiogram demonstrated an aneurysm without thrombus involving the third portion of axillary artery, 25mm in diameter. The aneurysm was thought to have occurred solitarily. At surgery, surrounding inflammatory reaction was mild, but the aneurysm which was 20mm in diameter was adherent to median nerve. So the aneurysm was resected, but a part of the adherent wall was left intact. The artery was transected at both sides of the aneurysm and reconstructed by a grafting with a prosthetic graft (PTFE with rings-6mm). Pathologic examination revealed that this case was true aneurysm with atherosclerotic changes. The patient had an uneventful postoperative recovery, and left the hospital 12 days after the operation.
Atherosclerotic aneurysm of the axillary artery is very rare. In a review of the literature, only 11 cases including our case have been reported. We present this rare case of atherosclerotic aneurysm of the axillary artery, together with some bibliographical comments.
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)