Hybrid imaging of a pseudoaneurysm of the descending thoracic aorta induced by a dorsal osteophyte: The silent killer

Vertebral osteophytes are the result of intervertebral disc degeneration and can occasionally damage the aorta located in their proximity. This paper describes the case of a 69-year-old woman with a pseudoaneurysm of the descending thoracic aorta caused by a progressively growing dorsal osteophyte. The patient was asymptomatic as the pseudoaneurysm was an incidental finding diagnosed with an 18 F-FDG PET/CT and computed tomography angiography (CTA) performed during follow-up for breast cancer. The comparison between the latest 18 F-FDG PET/CTA performed and previous exams was crucial for the diagnosis. In fact, the authors were able to demonstrate the progressive growth of the osteophyte and the subsequent development of the pseudoaneurysm. Both morphological features and metabolic behaviors supported the diagnosis. The pseudoaneurysm was successfully treated with thoracic endograft.