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Case Reports
. 2025 Oct 28;17(10):e95624.
doi: 10.7759/cureus.95624. eCollection 2025 Oct.

Unusual Presentation of Giant Cell Arteritis With Localised Temporal Artery Aneurysm

Syed A Ahmad  1 , Niazi Khairi  1 , Meeran Hussain  1 , Mark Lloyd  2
Affiliations
Case Reports

Unusual Presentation of Giant Cell Arteritis With Localised Temporal Artery Aneurysm

Syed A Ahmad et al. Cureus. .

Abstract

Giant cell arteritis (GCA) is a granulomatous vasculitis of medium and large-sized arteries occurring in older adults. Skip lesions are well described, but to our knowledge, localised aneurysm formation in the context of normocalcaemic, non-progressive GCA has not been reported. We report a case of a 74-year-old male who presented with painless left-sided temporal artery swelling, with an aneurysm and halo sign on ultrasound Doppler (US Doppler). Inflammatory markers were normal. Biopsy of the affected segment confirmed granulomatous inflammation with giant cells. Without treatment, he remained well with subsequent normal inflammatory markers and the US Doppler and positron emission tomography (PET)-CT scan showing no progression of the disease. This case illustrates the wide spectrum of giant cell arteritis, with the inflammation here being restricted to a focal segment of the superficial temporal artery with normal inflammatory markers and no apparent progression or similar isolated pockets in other areas. The temporal artery aneurysm is also a complication that has not been seen before in the context of GCA. This highlights the importance of considering a diagnosis of GCA, even in the absence of a classical presentation and laboratory findings, based on a potential complication that can help uncover the underlying issue.

Keywords: colored flow doppler ultrasound; fdg pet/ct scan; giant cell arteritis (gca); temporal aortic aneurysm; temporal artertitis; vasculitis.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Colour Doppler ultrasound of this patient showing a transverse view of the frontal branch of the left temporal artery which demonstrates a classic "halo sign" representing the inflamed and swollen arterial walls that is a hallmark of GCA
GCA - giant cell arteritis
Figure 2
Figure 2. Colour Doppler ultrasound showing a longitudinal view of the frontal branch of the left temporal artery which demonstrates a thickened arterial wall with a narrowed lumen due to the inflamed and swollen arterial walls
Figure 3
Figure 3. A longitudinal section of his repeat temporal artery colour doppler in July 2025 which shows a patent proximal frontal branch of the temporal artery with no evidence of vessel wall thickening or occluded lumen. The affected part however could not be visualised due to the biopsy.
Figure 4
Figure 4. An FDG PET CT scan of the anterior (A) and posterior (B) body from the head to the pelvis, showing a normal radionucleotide uptake and no abnormal areas of inflammation
FDG - fluorodeoxyglucose; PET - positron emission tomography
See this image and copyright information in PMC

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