An aortic wall to vertebral body fistula presenting as a lytic lesion.

There have been multiple reported cases of aortic fistulas but few cases of aorta to vertebral body fistulas and no aortic wall to vertebral body fistulas have been reported. Here we present a case of a patient who is status post thoracic aortic aneurysm (TAA) repair and found to have a lytic vertebral body lesion. Biopsy of the mass revealed blood products without evidence of malignancy and further investigation revealed a fistulous tract between the aortic wall and the vertebral body causing a vertebral body hematoma.