Isolated retroaortic left innominate vein in an adult without cardiac or aortic anomalies
A 68-year-old man was recovering from bacterial pneumonia involving both lungs. Patient had loss of weight and appetite. He did not have any heart disease. His clinical examination was unremarkable. No significant cardiac abnormality was noted on auscultation and in electrocardiography. However, his blood levels showed persistently high eosinophil count. Chest radiograph was unremarkable except for resolving pneumonia. Contrast-enhanced computed tomography (CT) scan of thorax, abdomen, and pelvis was done in dual-energy CT scanner (SOMATOM Definition Flash, Siemens Healthcare, Erlangen, Germany) to rule out any underlying neoplasm. No definite mass was noted in the CT. Incidentally, the left innominate vein had an abnormal course [] behind the ascending aorta before joining the right innominate vein to form the SVC which was normal in position (on the right side). The volume-rendered three-dimensional images obtained by dual-energy based bone removal clearly showed the relationship with the aortic arch []. The arch of aorta was left-sided. Heart was normal in CT scan. The anomalous course of the retroaortic innominate vein was highlighted in the report because of its clinical implications.