Lab Studies:
No labs were obtained
Other Studies:
To further evaluate the mass, the patient underwent several imaging studies. Ultrasound revealed a pulsatile mass located superior to the left clavicle in the midclavicular line with noted asymmetry as compared to the right side Case Photo #1 . A CTA was subsequently performed which demonstrated mild aneurysmal change at the mid-segment of the left subclavian artery. There was no thrombus or inflammatory change Case Photo #2 . The imaging also identified bilateral cervical ribs, with an anterolateral fusion of the cervical rib to the first thoracic rib on the left side Case Photo #3 . Given the concern for thoracic outlet syndrome, the patient underwent a CTA chest with thoracic outlet syndrome protocol. This demonstrated a stable aneurysm on the left Case Photo #4 . Additionally, there was no significant compression of the subclavian artery by the clavicle or cervical rib, both in a neutral and hyperabducted position Case Photo #5 .
Consultations:
The patient was referred to vascular surgery
Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.