An unusual mass in unusual gender

Isolated internal iliac artery aneurysms (IAAs) are rarely encountered in clinical practice, with an estimated incidence of 0.4%. They are more commonly seen in men aged 65 to 70 years, with a male to female ratio of 6:1 or greater. Smoking, hypertension, atherosclerosis, and male sex are the well-known risk factors for the development of IAAs. The vast majority of cases are found incidentally during ultrasound, CT, or angiography. Aneurysmal vessel size is the most important rupture determinant. Therefore, large aneurysms should be treated surgically or with endovascular coil embolization to prevent devastating complications, such as rupture and subsequent life-threatening bleeding. Patients with aneurysm of less than 3 cm in size can be managed conservatively with regular monitoring (1)