We here report the case of a 55-year old patient, with a history of recurrent buccal aphthosis, hospitalized for pelvic pain of sudden onset. Clinical examination showed sensitive pulsatile pelvic mass with blowing sound suggesting vascular origin. Examination of external genitalia showed scrotal scar after healing of aphthous ulcers. Laboratory test showed inflammatory syndrome with CRP levels of 80 mg/L, syphilis serological test was negative, doppler ultrasonography revealed primary aneurysm of the right common iliac artery and arteriography confirmed the diagnosis. The diagnosis of Behcet's disease was retained because of bipolar aphthosis and vascular involvement. Treatment was based on surgical resection of the aneurysm, bolus corticosteroids for three days, then oral corticosteroids and monthly intravenous cyclophosphamide infusion. Patient's outcome was favorable.
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