Pulmonary artery pseudoaneurysm after thoracic radiation therapy: A case report and review of the literature

Pulmonary artery pseudoaneurysm (PAP) is a rare cause of hemoptysis. Potential causes include trauma, infection, or medical interventions. There is a risk of rupture, which is associated with a high mortality rate. We describe a 72-year-old patient, with a past medical history of a lung carcinoma for which she was treated with chemoradiotherapy 6 years prior, who presented with hemoptysis. She was hemodynamically stable and there were no other complaints. CT angiography of the thorax showed a PAP originating from a branch of the right pulmonary artery in the previously irradiated area. The patient was successfully treated by an embolization with plugs. Treatment of lung carcinoma with chemoradiotherapy can result in the development of a PAP. Clinicians should be aware of this complication, even years after the therapy. In literature, only a few cases of PAP in patients treated with (chemo)radiotherapy for lung cancer are described, with a maximum interval up to 7 years. A pulmonary pseudo-aneurysm can present with moderate to massive haemoptysis. Potential causes include trauma, infection, cancer, or iatrogenic causes such as (chemo)radiotherapy. The gold standard for diagnosis is a CTA of the chest with contrast in pulmonary circulation, and endovascular embolization is an effective treatment in most cases. image