Vertebral-body erosion in thoracic aortic aneurysm
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A 74-year-old man presented with acute back pain but without neurologic symptoms. The blood pressure was normal. He had a history of hypertension, open repair of an aortic infrarenal aneurysm, and end-stage renal failure that required hemodialysis. Computed tomography revealed a thoracic aneurysm that measured 8.1 cm by 11.7 cm in the greatest dimensions on the axial view and well-corticated erosions of thoracic vertebrae 10 and 11 (Panel A shows the coronal view, Panel B the axial view, and Panel C the sagittal view; yellow arrows show the aneurysm, red arrows the erosion, and the blue arrow thoracic vertebra 11). Thoracic vertebral erosion, which is more often seen after aortic graft surgery, is a rare complication of thoracic aortic aneurysm. The suggested mechanism is repetitive mechanical pressure causing relative ischemia in the bone, which leads to lysis and bone destruction...

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