512870
research-article2013
PVSXXX10.1177/1531003513512870Perspectives in Vascular Surgery and Endovascular TherapyKuy et al
Article
Ruptured Mycobacterial Aneurysm of the Carotid Artery
Perspectives in Vascular Surgery and Endovascular Therapy 2014, Vol. 25(3-4) 53–56 © The Author(s) 2013 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1531003513512870 pvs.sagepub.com
SreyRam Kuy, MD, MHS1, Anahita Dua, MD1,2, Sapan S. Desai, MD, PhD, MBA4, Henryk Baraniewski, MD3, and Cheong J. Lee, MD1
Abstract Mycotic aneurysms resulting from intravesical bacillus Calmette-Guérin (BCG) treatment are exceptionally rare. We report on the case of a 73-year-old man who underwent intravesical therapy of BCG for bladder carcinoma and developed a right neck mass. A carotid pseudoaneurysm within a fibrotic mass was noted on surgical exploration. Radical resection was performed followed by a polytetrafluoroethylene interposition graft. Final pathology revealed necrotizing granulomas and multinucleated giant cells concerning for tuberculoma. Intravesicular BCG immunotherapy is an accepted treatment for patients with urothelial carcinoma. Carotid aneurysms are exceptionally rare in this setting and should prompt evaluation for systemic tuberculoid dissemination. Keywords carotid aneurysm, mycotic, aneurysm repair BCG, tuberculosis
Introduction Mycotic aneurysms are exceptionally unusual developments following intravesical instillation of bacillus Calmette-Guérin (BCG) for treatment of bladder carcinoma.1-3 BCG is a live, attenuated form of Mycobacterium bovis, that has been used as the mainstay of immunotherapy against superficial bladder carcinoma since 1976.4 More than 95% of patients undergoing BCG treatment have no significant side effects.4 A study by Lamm et al5 examining more than 2000 patients who received intravesical BCG reported the most common side effects as fever (2.9%), hematuria (1%), and infectious granulomas (
research-article2013
PVSXXX10.1177/1531003513512870Perspectives in Vascular Surgery and Endovascular TherapyKuy et al
Article
Ruptured Mycobacterial Aneurysm of the Carotid Artery
Perspectives in Vascular Surgery and Endovascular Therapy 2014, Vol. 25(3-4) 53–56 © The Author(s) 2013 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1531003513512870 pvs.sagepub.com
SreyRam Kuy, MD, MHS1, Anahita Dua, MD1,2, Sapan S. Desai, MD, PhD, MBA4, Henryk Baraniewski, MD3, and Cheong J. Lee, MD1
Abstract Mycotic aneurysms resulting from intravesical bacillus Calmette-Guérin (BCG) treatment are exceptionally rare. We report on the case of a 73-year-old man who underwent intravesical therapy of BCG for bladder carcinoma and developed a right neck mass. A carotid pseudoaneurysm within a fibrotic mass was noted on surgical exploration. Radical resection was performed followed by a polytetrafluoroethylene interposition graft. Final pathology revealed necrotizing granulomas and multinucleated giant cells concerning for tuberculoma. Intravesicular BCG immunotherapy is an accepted treatment for patients with urothelial carcinoma. Carotid aneurysms are exceptionally rare in this setting and should prompt evaluation for systemic tuberculoid dissemination. Keywords carotid aneurysm, mycotic, aneurysm repair BCG, tuberculosis
Introduction Mycotic aneurysms are exceptionally unusual developments following intravesical instillation of bacillus Calmette-Guérin (BCG) for treatment of bladder carcinoma.1-3 BCG is a live, attenuated form of Mycobacterium bovis, that has been used as the mainstay of immunotherapy against superficial bladder carcinoma since 1976.4 More than 95% of patients undergoing BCG treatment have no significant side effects.4 A study by Lamm et al5 examining more than 2000 patients who received intravesical BCG reported the most common side effects as fever (2.9%), hematuria (1%), and infectious granulomas (
