Spontaneous bilateral hemothorax in neurofibromatosis type 1 due to internal thoracic artery aneurysm: Case report.

Int J Surg Case Rep

Universidade Federal do Vale do São Francisco, Av. Jose de Sá Maniçoba, s/n Centro. Petrolina, PE, 56304917, Brazil. Electronic address:

Published: February 2020

Introduction: Vascular lesions are associated with neurofibromatosis 1, including stenosis and aneurysms.

Presentation Of A Case: A 43-year-old man presented with sudden respiratory failure in our emergency medical service. Physical examination suggested diagnosis of neurofibromatosis. Chest computed tomography revealed a sizeable bilateral hemothorax. He was then submitted to arteriography, which evidenced the right internal thoracic artery aneurysm. The aneurysm was selectively catheterized and embolized, followed by a video-assisted thoracoscopy surgery to drain the hemothorax.

Discussion: The bleeding dissected to both pleural cavities, causing the bilateral hemothorax. Although the patient did not have a medical diagnosis of neurofibromatosis before the occurrence, the presence of clinical signs of the disease, associated with the exclusion of other causes for hemothorax, allowed differential diagnosis and appropriate treatment.

Conclusion: The differential diagnosis of neurofibromatosis should be advanced in cases of spontaneous bleeding. In patients diagnosed with neurofibromatosis, the risk of spontaneous bleeding due to the possibility of aneurysmal formation should be considered.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044636PMC
http://dx.doi.org/10.1016/j.ijscr.2020.02.026DOI Listing

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