{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T17:58:28Z","timestamp":1777485508609,"version":"3.51.4"},"reference-count":13,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,11,9]]},"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:p>Ehlers-Danlos syndrome (EDS) type IV is a hereditary autosomal dominant disease associated with skin and vascular fragility, hyperextensibility and joint hypermobility. Spontaneous arterial rupture is one of its higher-risk features.<\/jats:p>\n               <jats:p>The authors describe a case of a woman with EDS type IV who presented with a spontaneous breast haematoma associated with a pseudoaneurysm of a branch of the left internal mammary artery. The patient underwent a minimally invasive endovascular approach that was uneventful. However, 6\u2009months later, she presented in the emergency room with a similar episode on the contralateral breast. There were no signs of active bleeding, and she stayed under surveillance. Nine months later, she was asymptomatic.<\/jats:p>\n               <jats:p>Aneurysms of branches of the internal mammary artery are rare and prone to rupture. Early diagnosis and treatment are imperative, and this case demonstrates that an endovascular approach is a safe treatment option.<\/jats:p>","DOI":"10.1136\/bcr-2023-256962","type":"journal-article","created":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T12:30:53Z","timestamp":1700656253000},"page":"e256962","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Spontaneous rupture of breast pseudoaneurysm: a rare case"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9968-2720","authenticated-orcid":false,"given":"Joana","family":"Mafra","sequence":"first","affiliation":[{"name":"Department of Gynecology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3538-7757","authenticated-orcid":false,"given":"Verena","family":"Pires","sequence":"additional","affiliation":[{"name":"Department of Radiology, Centro Hospitalar e Universit\u00e1rio de Coimbra EPE, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cl\u00e1udia","family":"Andrade","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6239-0022","authenticated-orcid":false,"given":"\u00c2ngela Reis","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal"},{"name":"Centro Acad\u00e9mico Cl\u00ednico de Coimbra, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,11,22]]},"reference":[{"key":"2025082622530321000_16.11.e256962.1","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.20344\/amp.1405","article-title":"Ehlers-Danlos syndrome type IV in association with a (C.970G>a) mutation in the COL3A1 gene","volume":"24","author":"Rebelo","year":"2012","journal-title":"Acta Med Port"},{"key":"2025082622530321000_16.11.e256962.2","doi-asserted-by":"crossref","DOI":"10.1186\/1750-1172-2-32","article-title":"Ehlers-Danlos syndrome type IV","volume":"2","author":"Germain","year":"2007","journal-title":"Orphanet J Rare Dis"},{"key":"2025082622530321000_16.11.e256962.3","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1056\/NEJM200102013440522","article-title":"Clinical and genetic features of Ehlers\u2013Danlos syndrome type IV, the vascular type","volume":"344","year":"2001","journal-title":"N Engl J Med"},{"key":"2025082622530321000_16.11.e256962.4","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1016\/j.jvscit.2019.07.002","article-title":"Coil embolization of bilateral internal mammary artery aneurysms in the setting of a heterozygous missense variant of unknown significance in COL5A1 and fibromuscular dysplasia","volume":"5","author":"Chen","year":"2019","journal-title":"J Vasc Surg Cases Innov Tech"},{"key":"2025082622530321000_16.11.e256962.5","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1590\/S0041-87812001000600004","article-title":"Recurrent spontaneous breast hematoma: report of a case and review of the literature","volume":"56","author":"Kanegusuku","year":"2001","journal-title":"Rev Hosp Clin Fac Med Sao Paulo"},{"key":"2025082622530321000_16.11.e256962.6","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.clinimag.2020.07.023","article-title":"Spontaneous breast hematoma as a complication of anticoagulation therapy requiring angiography and embolization","volume":"69","author":"Dunlap","year":"2021","journal-title":"Clin Imaging"},{"key":"2025082622530321000_16.11.e256962.7","doi-asserted-by":"crossref","first-page":"257","DOI":"10.4274\/ejbh.galenos.2023.2023-3-8","article-title":"Breast hematoma: a rare complication of anticoagulant and antiplatelet use and review of the literature","volume":"19","author":"Da\u011ftekin","year":"2023","journal-title":"Eur J Breast Health"},{"key":"2025082622530321000_16.11.e256962.8","doi-asserted-by":"crossref","DOI":"10.4103\/jpgm.JPGM_954_20","article-title":"Spontaneous breast hematoma following thrombolytic therapy","volume":"67","author":"Moorthy","year":"2021","journal-title":"J Postgrad Med"},{"key":"2025082622530321000_16.11.e256962.9","doi-asserted-by":"publisher","DOI":"10.1148\/rg.317115503"},{"key":"2025082622530321000_16.11.e256962.10","doi-asserted-by":"crossref","first-page":"S173","DOI":"10.1148\/rg.25si055503","article-title":"Pseudoaneurysms and the role of minimally invasive techniques in their management","volume":"25 Suppl 1","author":"Saad","year":"2005","journal-title":"Radiographics"},{"key":"2025082622530321000_16.11.e256962.11","unstructured":"Khan YS , Sajjad H . Anatomy, Thorax, Mammary gland [U.S. National Library of Medicine]. 2023 Available: https:\/\/pubmed.ncbi.nlm.nih.gov\/31613446\/"},{"key":"2025082622530321000_16.11.e256962.12","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/j.avsg.2019.10.045","article-title":"Endovascular repair of bilateral internal mammary artery aneurysms in a patient with Marfan syndrome","volume":"64","author":"Mertens","year":"2020","journal-title":"Ann Vasc Surg"},{"key":"2025082622530321000_16.11.e256962.13","doi-asserted-by":"crossref","DOI":"10.1590\/1677-5449.20210223","article-title":"Successful endovascular repair with coil embolization of ruptured right internal thoracic artery aneurysm","volume":"21","author":"Shrimanth","year":"2022","journal-title":"J Vasc Bras"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-256962","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T05:53:09Z","timestamp":1756273989000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-256962"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11]]},"references-count":13,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11,22]]},"published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1136\/bcr-2023-256962"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-256962","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11]]}}}