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Bae M, Huh U, Lee CW, Kim JW. Venous adventitial cystic disease is a very rare disease that can cause deep vein thrombosis: A case report. World J Clin Cases 2023; 11:8170-8175. [PMID: 38130778 PMCID: PMC10731187 DOI: 10.12998/wjcc.v11.i34.8170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/26/2023] [Accepted: 11/28/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Venous adventitial cystic disease (VACD) is a rare disease characterized by cysts, filled with a gelatinous mucous substance similar to joint fluid, in the adventitia of blood vessels adjacent to the joints. It is often misdiagnosed as deep vein thrombosis (DVT), femoral varices, venous tumors, or lymphadenopathy. CASE SUMMARY A 69-year-old woman visited our hospital with a complaint of swelling in the right lower extremity. The patient was diagnosed with DVT and prescribed apixaban at an outpatient clinic. After 3 wk, the patient was hospitalized again because of sudden swelling in the right lower extremity. We diagnosed VACD and performed surgery for cyst removal as well as patch angioplasty and thrombectomy of the right common femoral vein. The patient received anticoagulants for 6 mo and has been doing well without recurrence for 1 year postoperatively. CONCLUSION Recurrent VACD requires complete removal of the connections to the joint cavity to prevent recurrence.
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Affiliation(s)
- Miju Bae
- Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Busan 49241, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
| | - Up Huh
- Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Busan 49241, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
| | - Chung Won Lee
- Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Busan 49241, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
| | - Jong Won Kim
- Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Busan 49241, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
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Abstract
OBJECTIVES Cystic adventitial disease is an extremely rare vascular disorder and is often misdiagnosed. In order to improve the knowledge and treatment of this disease, a case of venous cystic adventitial disease was reported. METHODS The whole processes about the diagnosis and treatment of one patient with venous cystic adventitial disease was retrospectively studied. RESULTS This case of venous cystic adventitial disease was diagnosed accurately by contrast-enhanced computed tomography and treated successfully by surgical resection. No complications were detected after one-year post-operative follow-up. CONCLUSIONS Surgical resection is a safe and effective method for the treatment of venous CAD.
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Affiliation(s)
- Facai Guo
- Department of Vascular Surgery, Lanzhou University Second Hospital, Lanzhou, China
| | - Yi Guo
- Department of General Surgery, Chongqing University Central Hospital (Chongqing Emergency Medical Center), Chongqing, China
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Mousa AY, Alhalbouni S, Abu-Halimah S, Gill G, Sadek B, Nanjundappa A, Hass SM, AbuRahma AF. Cystic Adventitial Disease of the Common Femoral Vein. Vasc Endovascular Surg 2013; 47:569-72. [PMID: 23873672 DOI: 10.1177/1538574413497110] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We report on a 52-year-old female patient who presented with a 6-month history of right lower extremity swelling and tenderness. The patient was treated as an outpatient with full anticoagulation, without any improvement. Her medical history was significant for hypertension and high cholesterol, and she had a full coagulopathy profile that was negative for any hypercoagulable syndrome. On examination, the patient was moderately obese, with significant tenderness over the medial aspect of the right groin. A venous duplex examination revealed hypoechoic structure ± acute deep vein thrombosis of right common femoral vein (CFV). A computed tomography of the venous phase revealed an eccentric compression over the medial wall of the right CFV. During surgical exploration, adventitial cystic mucinous disease was enucleated from the medial wall of the right CFV, and the pathological examination confirmed the diagnosis. The postoperative course was uneventful, and all swelling and tenderness were completely resolved. The patient continued to do well, and she had an unremarkable venous duplex evaluation at her 6-month follow-up.
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Affiliation(s)
- Albeir Y. Mousa
- Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, WV, USA
- Department of Surgery, Charleston Area Medical Center, Charleston, WV 25304
| | - Saadi Alhalbouni
- Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, WV, USA
- Department of Surgery, Charleston Area Medical Center, Charleston, WV 25304
| | - Shadi Abu-Halimah
- Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, WV, USA
- Department of Surgery, Charleston Area Medical Center, Charleston, WV 25304
| | - Gurpreet Gill
- Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, WV, USA
- Department of Surgery, Charleston Area Medical Center, Charleston, WV 25304
| | - Betro Sadek
- Massachusetts General Hospital, Harvard Medical School Boston, MA, USA
| | - Aravinda Nanjundappa
- Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, WV, USA
- Department of Surgery, Charleston Area Medical Center, Charleston, WV 25304
| | - Stephen M. Hass
- Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, WV, USA
- Department of Surgery, Charleston Area Medical Center, Charleston, WV 25304
| | - Ali F. AbuRahma
- Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, WV, USA
- Department of Surgery, Charleston Area Medical Center, Charleston, WV 25304
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Spinner RJ, Desy NM, Agarwal G, Pawlina W, Kalra M, Amrami KK. Evidence to support that adventitial cysts, analogous to intraneural ganglion cysts, are also joint-connected. Clin Anat 2012; 26:267-81. [DOI: 10.1002/ca.22152] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 07/26/2012] [Indexed: 11/09/2022]
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