The Teaching Point

The top differential diagnosis for a newly diagnosed lytic bone lesion is typically metastatic malignancy in a 69-year-old patient. However, a lytic vertebral lesion in a patient who is status post aortic aneurysm repair may be due to an aortic wall to vertebral body fistula. This case is to highlight this possibility and educate radiologists to assess the integrity of the aortic wall and look for a possible connection between the aorta and the vertebral body in order to make the diagnosis and prevent the risk of hemorrhage and possible sepsis.






Bookmark and Share

From the manuscript

An aortic wall to vertebral body fistula presenting as a lytic lesion

Free full text article: An aortic wall to vertebral body fistula  presenting as a lytic lesion

Abstract
There have been multiple reported cases of aortic fistulas but few cases of aorta to vertebral body fistulas and no aortic wall to vertebral body fistulas have been reported. Here we present a case of a patient who is status post thoracic aortic aneurysm (TAA) repair and found to have a lytic vertebral body lesion. Biopsy of the mass revealed blood products without evidence of malignancy and further investigation revealed a fistulous tract between the aortic wall and the vertebral body causing a vertebral body hematoma.






References



1. Hiratzka LF, Bakris GL, Beckman JA, Bersin RM, Carr VF, Casey DE, Jr.. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease: executive summary. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine Catheter Cardiovasc Interv
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


2. Svensson LG, Crawford ES, Hess KR, Coselli JS, Safi HJ. Experience with 1509 patients undergoing thoracoabdominal aortic operations. J Vasc Surg 1993;17(2):357-68; discussion 68-70
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


3. Kalsch H, Lehmann N, Mohlenkamp S, Becker A, Moebus S, Schmermund A. Body-surface adjusted aortic reference diameters for improved identification of patients with thoracic aortic aneurysms: results from the population-based Heinz Nixdorf Recall study. Int J Cardiol 2013;163(1):72-8
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


4. Olsson C, Thelin S, Stahle E, Ekbom A, Granath F. Thoracic aortic aneurysm and dissection: increasing prevalence and improved outcomes reported in a nationwide population-based study of more than 14,000 cases from 1987 to 2002. Circulation 2006;114(24):2611-8
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


5. Reed D, Reed C, Stemmermann G, Hayashi T. Are aortic aneurysms caused by atherosclerosis? Circulation. 1992;85(1):205-11
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


6. Ueno M, Iguro Y, Nagata T, Sakata R. Aortoenteric fistula after endovascular stent grafting for an abdominal aortic aneurysm: report of a case. Surg Today 2006;36(6):546-8
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


7. Fink HA, Lederle FA, Roth CS, Bowles CA, Nelson DB, Haas MA. The accuracy of physical examination to detect abdominal aortic aneurysm. Arch Intern Med 2000;160(6):833-6
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


8. Akkersdijk GJ, van Bockel JH. Ruptured abdominal aortic aneurysm: initial misdiagnosis and the effect on treatment. Eur J Surg 1998;164(1):29-34
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


9. Booher AM, Eagle KA. Diagnosis and management issues in thoracic aortic aneurysm. Am Heart J 2011;162(1):38-46 e1
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


10. Hamaoka T, Madewell JE, Podoloff DA, Hortobagyi GN, Ueno NT. Bone imaging in metastatic breast cancer. J Clin Oncol 2004;22(14):2942-53
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


11. Tirumani SH, Shinagare AB, Jagannathan JP, Krajewski KM, Munshi NC, Ramaiya NH. MRI features of extramedullary myeloma. AJR Am J Roentgenol 2014;202(4):803-10
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


12. Soutar R, Lucraft H, Jackson G, Reece A, Bird J, Low E. Guidelines on the diagnosis and management of solitary plasmacytoma of bone and solitary extramedullary plasmacytoma. Clin Oncol (R Coll Radiol) 2004;16(6):405-13
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


13. Murphey MD, Andrews CL, Flemming DJ, Temple HT, Smith WS, Smirniotopoulos JG. From the archives of the AFIP. Primary tumors of the spine: radiologic pathologic correlation Radiographics
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


14. Pastushyn AI, Slin`ko EI, Mirzoyeva GM. Vertebral hemangiomas: diagnosis, management, natural history and clinicopathological correlates in 86 patients. Surg Neurol 1998;50(6):535-47
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


15. Hudson TM. Fluid levels in aneurysmal bone cysts: a CT feature. AJR Am J Roentgenol 1984;142(5):1001-4
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


16. Guo W, Xu W, Huvos AG, Healey JH, Feng C. Comparative frequency of bone sarcomas among different racial groups. Chin Med J (Engl) 1999;112(12):1101-4
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


17. Murphey MD, Nomikos GC, Flemming DJ, Gannon FH, Temple HT, Kransdorf MJ. From the archives of AFIP. Imaging of giant cell tumor and giant cell reparative granuloma of bone: radiologic-pathologic correlation Radiographics
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine




Search for articles with similar topics:

Keyword search:

1. Aortic aneurysm

2. fistula

3. endoleak

4. vertebral body hematoma

5. lytic spine lesion


This article belongs to the Neuro section.


Search for more in the Internet

Peer-reviewed Radiology Search




Discuss it!

Bookmark and Share




© Journal of Radiology Case Reports - The Interactive Radiology Journal
Affiliated journal of Radiolopolis - The International Radiology Community


The Journal of Radiology Case Reports