title: Edoxaban treatment for pulmonary arterial thromboembolism associated with azygous vein aneurysm.
abstract: A 76-year-old woman, diagnosed 5 years previously with an asymptomatic mediastinal bronchogenic cyst, was referred to our department as the mass had grown slightly larger. Contrast-enhanced computed tomography and magnetic resonance imaging scans revealed an azygous vein aneurysm with a pulmonary arterial thromboembolism. The patient was treated with heparin for 5 days, and anticoagulation therapy with edoxaban was continued for 12 months. The thrombus resolved, and the aneurysm remained unchanged. An azygous vein aneurysm is a very rare condition that causes pulmonary arterial thromboembolism. Although surgical resection is indicated for patients with azygous vein aneurysms with a risk of rupture and pulmonary embolism, we chose anticoagulation therapy because of the patient's advanced age. This case suggests that the azygous vein aneurysm is one of the differential diagnoses for a mediastinal mass and that anticoagulation therapy can be the treatment of choice for pulmonary arterial thromboembolism with an azygous vein aneurysm.
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine Keio University School of Medicine Tokyo Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Mochimaru
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine Keio University School of Medicine Tokyo Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawada
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine Keio University School of Medicine Tokyo Japan.
authors.forename: Shotaro
authors.initials: S
authors.lastname: Chubachi
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine Keio University School of Medicine Tokyo Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tsutsumi
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine Keio University School of Medicine Tokyo Japan.
authors.forename: Hanako
authors.initials: H
authors.lastname: Hasegawa
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine Keio University School of Medicine Tokyo Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Betsuyaku
keywords: Azygous vein aneurysm; edoxaban; pulmonary arterial thromboembolism