Ectasia of the jugular system is unusual in children. We present here a pediatric case with internal jugular vein phlebectasia, and an adult case with a venous aneurysm. These two ectasias were observed as nonpulsatile, elongated or round neck masses that enlarges with the Valsalva maneuver or speaking. Computed tomography (CT), magnetic resonance imaging (MRI), ultrasound and angiography have all been used in the diagnosis of ectasia. However, CT with a contrast agent make it possible to obtain a clear diagnosis, and allows the detection of thrombus formation.
In our adult case, a thrombus in the aneurysm was suggested. After CT with a contrast agent, angiography was useful to detect the thrombosis and its connection with the internal jugular vein. Surgical resection of the jugular aneurysm was undertaken to avoid the risk of embolization in this case. In our pediatric case, the phlebectasia has been examined regularly because the lesion was stable in size, and there was no thrombus formation. We recommend surgical resection only if the lesion forms a thrombus, increases in size, or causes cosmetic deformity.