An aneurysm of right-sided aortic arch with mirror-image brachiocephalic branching.

The patient is a 63-year-old man whose right retroesophageal aortic arch with mirror-image braciocephalic branching was discovered incidentally on computer tomography (CT), performed after a minor motor vehicle accident 12 years ago. The size of the aortic arch was normal at that time. The patient had no other congenital cardiac anomalies. He has received another CT as a part of the staging evaluation for renal cell carcinoma. This showed asymmetric aneurysm of the aortic arch measuring 4.9 cm in the widest diameter. The patient is asymptomatic and being followed closely with CT scans every 6 months. This represents an extremely rare case of an aneurysm of right-sided aortic arch with mirror-image brachiocephalic branching. We report the case and provide a short review of the relevant literature.