Thrombosis of an External Jugular Vein Aneurysm: An Uncommon Cause of Cervical Mass

Abstract

Introduction: Venous aneurysms are rare vascular anomalies, particularly external jugular vein (EJV) aneurysms. Their nonspecific clinical features complicate diagnosis, and thrombosis within these aneurysms, though uncommon, heightens the risk of serious complications like thrombus extension and pulmonary embolism.

Case Report: We present a 62-year-old hypertensive female with a 12-month history of a fluctuating, painless neck mass that increased in size during Valsalva maneuvers. Recently, the mass became persistent and painful, prompting medical evaluation. Examination revealed a firm, mobile, slightly tender mass on the left neck. Imaging, including CT and venous Doppler ultrasound, indicated an indeterminate lesion. Surgical cervicotomy and vein ligation confirmed a thrombosed EJV aneurysm. Postoperatively, anticoagulation led to complete recanalization, with no recurrence at six months.

Discussion: Thrombosed venous aneurysms pose a diagnostic challenge due to their rarity and nonspecific presentation. This case highlights the need for early surgical intervention and anticoagulation to avert complications.

Conclusion: This case emphasizes the importance of considering thrombosed EJV aneurysms in cervical mass differentials, as prompt diagnosis and management can significantly enhance patient outcomes.