Abstract
A 43-year-old woman had intermittent claudication in the left leg one month prior to visiting the hospital. The ankle brachial index was lower than normal. Computed tomography showed an obstruction of the left external iliac artery. Intravascular ultrasound showed an extravascular cystic lesion. The cystic lesion was removed surgically with the external iliac artery involved, which was replaced by an artificial graft. The histopathological diagnosis was adventitial cystic disease. Postoperatively, her symptom disappeared and the left ABI was normalized. Adventitial cystic disease is an unusual cause of intermittent claudication. The popliteal artery is most commonly affected. The external iliac artery is reported to be rarely involved with this disease. The exact cause of this disease has not been revealed and various theories have been proposed for its etiology. In this case, the cyst was considered to be connected to the hip joint bursa. This finding supports the developmental theory that the bursal cyst and the adventitial cyst have the same mesenchymal origin.
