External Jugular Venous Aneurysm: Report of a Case and Review of the Japanese Literature

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  • Uchida Norio
    Department of Vascular Surgery, Mito Red Cross Hospital

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  • 外頸静脈の静脈性血管瘤の1例

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<p>Venous aneurysms of the jugular vein are one of the rare causes of neck swelling, and primary venous aneurysms of the external jugular vein are extremely rare. We here present a case of this entity. A 45-year-old woman presented with a painful and suddenly growing mass in the left neck. The neck lump enlarged on Valsalva maneuver. A computed tomography angiography revealed a saccular venous aneurysm of the external jugular vein containing intraluminal thrombus. The maximal dimeter was 43×37×35 mm. We performed resection of the aneurysm and ligation of the external jugular vein. The histopathology of the mass showed a grossly dilated vein, with continuous aspects of the entire three layer of the venous wall, classifying it as a venous aneurysm. A brief review of the Japanese literature of this entity has been discussed. From 1987 to 2019, we found 36 cases of reported external jugular vein including our case. There were 4 male and 32 female patients, ranging in age from 4 to 86 years old with a median age of 53 years old. They were diagnosed by flow duplex imaging, CT or MRI. Almost all patients had saccular aneurysm. Aneurysms size ranged from 6 to 50 mm (median 30 mm). The affected sides were 16 in the left and 20 in the right. In all patients except for two cases, aneurysms were resected and venous continuity with a graft was found unnecessary. Venous aneurysms may cause thrombophlebitis and thrombus formation. However, no pulmonary embolism due to the thrombus in the external jugular venous aneurysm has been reported in the Japanese literature to the best of our knowledge. Surgical excision is indicated if they are symptomatic, enlarging or disfiguring.</p>

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