Rupture of a Brachial Artery Caused by a Humeral Osteochondroma

Chang-Bae Kong; Kwang-Youl Lee; Sang-Hyun Cho; Won Seok Song; Wan-Hyeong Cho; Dae-Geun Jeon; Soo-Yong Lee

doi:10.4055/jkoa.2013.48.4.297

Journal List > J Korean Orthop Assoc > v.48(4) > 1013241

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Kong, Lee, Cho, Song, Cho, Jeon, and Lee: Rupture of a Brachial Artery Caused by a Humeral Osteochondroma

Case Report

Journal of the Korean Orthopaedic Association 2013; 48(4): 297-301.

Published online: 28 August 2013

DOI: https://doi.org/10.4055/jkoa.2013.48.4.297

Rupture of a Brachial Artery Caused by a Humeral Osteochondroma

Chang-Bae Kong, M.D., Kwang-Youl Lee, M.D., Sang-Hyun Cho, M.D., Won Seok Song, M.D., Wan-Hyeong Cho, M.D., Dae-Geun Jeon, M.D., Soo-Yong Lee, M.D.

Department of Orthopedic Surgery, Korea Cancer Center Hospital, Seoul, Korea.

Correspondence to: Won Seok Song, M.D. Department of Orthopedic Surgery, Korea Cancer Center Hospital, 75 Nowon-ro, Nowon-gu, Seoul 139-706, Korea. TEL: +82-2-970-1244, FAX: +82-2-970-2403, wssongmd@gmail.com

Received 11 November 2012 Revised 3 May 2013 Accepted 5 June 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Pseudoaneurysm resulting from vascular impingement by an osteochondroma is extremely rare. The authors report on the case of a 16-year-old male who had a brachial artery pseudoaneurysm and vessel rupture associated with a humeral osteochondroma. This case suggests that pseudoaneurysm should be considered for the differential diagnosis in patients with soft tissue masses and a cuspidal osteochondroma located near the neurovascular bundle and recommends Doppler sonography or angiography.

Keywords: pseudoaneurysm, osteochondroma, brachial artery, vascular grafting

Figures and Tables

Figure 1

(A) Plain radiograph shows a left proximal humeral osteochondroma. (B) Three-dimentional reconstructed computed tomography (CT) image shows a medially protruded humeral osteochondroma. (C) Axial CT image demonstrates that this osteochondroma has a sharp beak toward the brachial neurovascular bundle.

Figure 2

(A) The shoulder T1 and (B) T2-weighted magnetic resonance (MR) axial images demonstrate soft tissue mass. (C) Enhance T1-weighted MR axial image shows pseudoaneurysm (arrow) arising from the compressed brachial artery which demonstrate a strong enhancement. (D) T2-weighted MR shows that this soft tissue mass has high signal intensity along the intermuscular septum.

Figure 3

(A) Intra-operative picture showing left brachial artery with associated pseudoaneurysm and hematoma. (B) The picture shows that additional incision and artificial vessel graft were performed.

Figure 4

(A, B) Post-operative plain radiographs show excised osteochondroma in the proximal medial meta-diaphysis of the left humerus. (C) Two months later after the operation, doppler ultrasonography shows vascular access dysfunction at the axillary artery and proximal arm.

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