title: Ruptured mycobacterial aneurysm of the carotid artery.
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.
authors.affiliation: 1Medical College of Wisconsin, Milwaukee, WI.
authors.forename: SreyRam
authors.initials: S
authors.lastname: Kuy
authors.forename: Anahita
authors.initials: A
authors.lastname: Dua
authors.forename: Sapan S
authors.initials: SS
authors.lastname: Desai
authors.forename: Henryk
authors.initials: H
authors.lastname: Baraniewski
authors.forename: Cheong J
authors.initials: CJ
authors.lastname: Lee
mesh_terms: D000283:Administration, Intravesical; D000368:Aged; D017541:Aneurysm, False / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D000785:Aneurysm, Infected / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000995:Antitubercular Agents / Q000627:therapeutic use; D001500:BCG Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D001706:Biopsy; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D006801:Humans; D008297:Male; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014375:Tuberculoma / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D014381:Tuberculosis, Cardiovascular / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D001749:Urinary Bladder Neoplasms
chemical_list: D000970:Antineoplastic Agents; D000995:Antitubercular Agents; D001500:BCG Vaccine; D011138:Polytetrafluoroethylene
keywords: aneurysm repair BCG; carotid aneurysm; mycotic; tuberculosis