Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 16, 2021; 9(11): 2655-2661
Published online Apr 16, 2021. doi: 10.12998/wjcc.v9.i11.2655
Surgical therapy for hemangioma of the azygos vein arch under thoracoscopy: A case report
Zhen-Xing Wang, Liang-Liang Yang, Zhe-Nan Xu, Pei-Yun Lv, Yue Wang
Zhen-Xing Wang, Liang-Liang Yang, Zhe-Nan Xu, Pei-Yun Lv, Yue Wang, Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China
Author contributions: Wang ZX and Yang LL designed the work and wrote the manuscript; Xu ZN and Lv PY researched the bibliography; Wang Y conceived the idea of publishing the case and supervised and corrected the manuscript.
Supported by Science and Technology Development Plan Project of Jilin Province, China, No. JJKH20201060KJ.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article are reported.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yue Wang, MD, PhD, Chief Physician, Professor, Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Erdao District, Changchun 130033, Jilin Province, China. w_yue@jlu.edu.cn
Received: December 13, 2020
Peer-review started: December 13, 2020
First decision: December 24, 2020
Revised: January 3, 2021
Accepted: February 22, 2021
Article in press: February 22, 2021
Published online: April 16, 2021
Abstract
BACKGROUND

Azygos vein aneurysms are extremely rare, and their pathogenesis is not clear. The overwhelming majority of patients have no obvious clinical symptoms and are found to have the disease by physical examination or by chance. There are few reports on the diagnosis of and treatment strategy for this disease. Moreover, the choice of therapeutic schedule and the treatment window are controversial.

CASE SUMMARY

We report a case of azygos vein arch aneurysm in a 53-year-old woman. The patient had symptoms of back pain, chest tightness, and choking. Enhanced chest computed tomography showed a soft-tissue mass in the right posterior mediastinum, which was connected to the superior vena cava. The enhancement degree in the venous phase was the same as that of the superior vena cava. The patient received video-assisted thoracoscopic surgery. After the operation, her back pain disappeared, and her dysphagia and chest tightness were also significantly relieved. The postoperative pathology confirmed hemangioma. The patient was discharged on the seventh day after surgery without any comp-lications.

CONCLUSION

Some patients with hemangioma of the azygos vein arch may experience dysphagia and chest tightness caused by the tumor compressing the esophagus and trachea. Enhanced computed tomography scanning is vital for the diagnosis of azygos vein aneurysms. In addition, despite the difficulty and risk of surgery, thoracoscopic surgery for azygos vein aneurysms is completely feasible.

Keywords: Azygos vein aneurysm, Hemangioma of the azygos vein arch, Mediastinal tumor, Thoracoscopic surgery, Case report

Core Tip: Azygos vein aneurysms are extremely rare. We present a patient with hemangioma of the azygos vein arch who experienced dysphagia and chest tightness caused by a tumor compressing the esophagus and trachea. The patient received video-assisted thoracoscopic surgery. We herein report the first case of a patient with choking symptoms due to the esophagus being compressed by an azygos vein aneurysm.