Abstract
Background Breast pseudoaneurysms are rare and most commonly associated with iatrogenic causes such as core needle or surgical excisional biopsies. Other causes include blunt force trauma, breast implants, or underlying malignancy. This report describes the presentation and management of a spontaneous breast pseudoaneurysm. Case Presentation A 55-year-old female with a past medial history of hypertension and hyperlipidemia presented to the emergency department with sudden onset of a pulsatile left breast mass after a coughing spell. Doppler ultrasound (US) revealed a pulsatile vascular structure with internal arterial waveforms concerning for a breast pseudoaneurysm. The patient underwent a chest computed tomography angiogram (CTA) that confirmed a pseudoaneurysm arising from the left internal mammary artery. Mammography and target ultrasound showed no findings suggestive of underlying malignancy. Conservative management with compression was initiated resulting in partial thrombosis. Repeat doppler US showed persistent internal flow, and therefore, US-guided thrombin injection was performed by vascular surgery with complete thrombosis. Conclusion Breast pseudoaneurysms can occur spontaneously and can be managed with both conservative and local invasive interventions.
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