A giant coronary aneurysm posing as a cardiac mass: The stepwise diagnosis, medical and surgical management of Behçet disease in an adolescent

Behçet's disease (BD) is a rare, systemic vasculitis characterized by recurrent oral and genital ulcers, ocular inflammation, and multiorgan involvement. Cardiovascular complications are uncommon in BD; however, when they occur, they are potentially life-threatening. Coronary artery aneurysms (CAAs) are one of the most severe vascular manifestations of BD, particularly in the pediatric population, where they remain poorly documented and their prognosis is largely unknown. Here, we report the case of a 13-year-old male patient with the diagnosis of BD who presented with a giant right coronary artery aneurysm initially identified as a cardiac mass on imaging. Due to the medically refractory and life-threatening nature of the aneurysm, the patient underwent coronary artery bypass grafting. This case highlights the rare but critical cardiovascular complications of BD in a pediatric patient and underscores the challenges in diagnosis and surgical management. Clinicians should maintain a high index of suspicion for vascular complications, including CAAs, in pediatric patients with BD.