Varied Presentation of Venous Ectasia Head and Neck: Case Series and Review of Literature

Idiopathic Facial Vein Aneurysm: A Case Report and Review of the Literature

Venous aneurysms of the head and neck, and in particular the facial vein, are rare lesions that present as soft, compressible masses. We describe a case of an idiopathic aneurysm of the facial vein. A comprehensive literature review of this entity was conducted to better understand the disease process. A 51-year-old female presented with a one-year history of a prominent but painless right submandibular mass that was more noticeable with maneuvers such as straining. An exam showed a painless, soft, compressible, right level 1b neck mass that enlarged with Valsalva. A computed tomography scan of the neck revealed a 2.7 cm enhancing mass adjacent to the right submandibular gland. Further workup included a direct puncture venography, which demonstrated an unruptured 3 cm venous aneurysm involving the right facial vein. Surgical excision was offered to the patient, which was completed without complications. Histopathology of the mass was consistent with a facial vein aneurysm and confirmed the suspected diagnosis. The patient was seen postoperatively in follow-up and was healing well. While facial vein aneurysms are rare, it is important to recognize, work up, and treat them appropriately. A painless compressible mass that enlarges with Valsalva is suggestive of the diagnosis. Management may vary on a case-by-case basis with surgical resection being the definitive treatment of choice.

Venous Ectasia of Retromandibular and Common Facial Veins: A Rare Clinical Entity

Venous ectasias are benign conditions of the neck, in which focal dilatations of veins occur. Internal jugular, external jugular or superficial veins are usually the affected ones in the neck. They are often ignored or misdiagnosed. Here we are reporting a patient with venous ectasia of the retromandibular vein and the common facial vein. A 25-year-old male presented to our out-patient department with an intermittent swelling over the right side of the neck that he had for one year. The swelling was more prominent on lying down and on Valsalva maneuver. Radiologic imaging was suggestive of venous ectasia of the retromandibular vein and the common facial vein. Surgical excision was done for aesthetic reasons and in fear of thrombosis. Intraoperatively, we noticed that it was arising from the retromandibular and the common facial veins. Venous ectasias of superficial veins are rare. We can consider these patients for surgical excision in view of the risk of thrombosis, thromboembolic events, rupture, and aesthetic reasons.