Unusual Case of an Idiopathic Thyrocervical Trunk Pseudoaneurysm: An Interesting Case Report.

Thyrocervical trunk pseudoaneurysms are very rare and usually occur after trauma or invasive procedures. Given its location and nature, thyrocervical trunk pseudoaneurysm typically presents with symptoms at presentation. Those that occur spontaneously and without symptoms are even more uncommon. The management of thyrocervical trunk pseudoaneurysm can be done in three main ways: endovascular, open, or hybrid (endovascular and open). This case report describes a 71-year-old male Hispanic patient who presented to the vascular surgery clinic with a left supraclavicular mass that he noticed 12 years ago. There was no significant past medical history or history of neck surgery/interventions. Besides the pulsatile mass, the patient did not endorse any other complaints. A duplex ultrasound (DUS) was obtained, and it was consistent with a pseudoaneurysm. A neck computed tomography angiogram (CTA) was subsequently obtained and confirmed the large (6.1×4.6×5 cm) pseudoaneurysm at the root of the left thyrocervical trunk. The decision was made to take him to the operating room. Using an open approach, the left thyrocervical trunk was dissected, and the pseudoaneurysm was exposed. The pseudoaneurysm was then resected, and a primary anastomosis of the vessel was performed. The patient tolerated the procedure well without complications. He was discharged on post-operative day 2 in stable condition. Short-term follow-up demonstrated no left supraclavicular mass recurrence on physical examination. The surgical incision is healing well. Thyrocervical trunk pseudoaneurysms are rare entities that can be detrimental to the patient if not treated optimally. Even if the patient remains asymptomatic or relatively asymptomatic, the incidence of embolization, thrombosis, or rupture is high. Open vascular intervention is recommended when the root of the trunk is involved.