A venous aneurysm, defined as a focal dilatation in a vein, is an uncommon vascular abnormality. It is to be distinguished from varicose veins, which are characterized by continuously dilated meandering and bending veins. A venous aneurysm can develop in all major veins, but multiple cervical venous aneurysms have rarely been reported, if ever. Herein, we report a case of venous aneurysms in the left external jugular vein and left subclavian vein.
A 64-year-old man was referred to our department from a general physician with a left supraclavicular mass. The mass was soft and painless, and increased in size when the patient performed the Valsalva maneuver. There was no prior history of trauma to that area. Doppler ultrasonography, dynamic computed tomography and magnetic resonance imaging revealed two aneurysms of the left external jugular vein and an aneurysm of the subclavian vein, and suggested the presence of a thrombus in one of the external jugular vein aneurysms. We resected the external jugular lesions with the aim of preventing pulmonary embolism, as well as for esthetic reasons. The resection was performed successfully, with no postoperative complications. Following the surgery, the patient has remained asymptomatic for 4 months. Histopathologically, one of the aneurysms contained a thrombus.
Venous aneurysm of the neck is usually asymptomatic, and is most frequently treated only for esthetic reasons. However, there are a few reports of pulmonary embolism arising from thrombus formation in the jugular and subclavian veins. We consider that surgery should be performed if the patient is deemed to be at the risk of developing pulmonary embolism from the thrombus. In the present patient, we did not resect the subclavian lesion because it was asymptomatic. Careful follow up is important considering the possibility of thrombus formation and rupture.
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