Fatal Expanding Thoracoabdominal Aneurysm in Known but Mistreated Behcet’s Disease in a Young Patient

Arterial involvement in Behcet’s disease has been previously described. We report a rare case of a large and long-segment thoracoabdominal aneurysm, which was associated with Behcet’s disease and had an unfavorable evolution. A 23-year-old man was diagnosed with Behcet’s disease, as revealed by a carotid aneurysm, and was treated with a prosthetic graft reconstruction as well as immunosuppressive therapy. The patient was lost to follow-up. He stopped the medications of his own will 1 month after his discharge from the hospital. Two years later, he presented with chest pain of 1 week’s duration. A large aneurysm involving a long aorta segment from the sinus of Valsalva to the abdominal aorta above the renal arteries was identified by computed tomography angiography. Unfortunately, the patient died despite immunosuppressive therapy and before any surgical or endovascular intervention could be performed. This rare observation supports the role of immunosuppressive therapy in preventing the recurrence of life-threatening vascular lesions in the management of Behcet’s disease.