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Biggs JH, Kalra M, Skinner JA, DeMartino RR. Adventitial cystic disease of the common femoral vein: an unusual cause of lower extremity swelling and review of the literature. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2021; 7:610-616. [PMID: 34746527 PMCID: PMC8551497 DOI: 10.1016/j.jvscit.2021.06.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/25/2021] [Indexed: 11/24/2022]
Abstract
We report the case of a 61-year-old man who had presented with acute unilateral limb swelling. Computed tomography venography and duplex ultrasound demonstrated compression of the right common femoral vein by a common femoral vein adventitial cyst. Before intervention, the patient had developed an acute deep vein thrombosis of the right common femoral vein and great saphenous vein. Preoperative magnetic resonance imaging demonstrated concern for synovial connection. After 6 months of anticoagulation therapy, the patient underwent adventitial cyst excision with ligation of the hip joint articular connection. At 4 months postoperatively, the patient was symptom free without cyst recurrence. The findings from the present case support the synovial theory for adventitial cystic disease.
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Affiliation(s)
- Joedd H Biggs
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn
| | - Manju Kalra
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn
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Yan H, Zhou C, Yan F, Wen X, Luo Y. Case 290: Intravascular Cystic Synovial Sarcoma. Radiology 2021; 299:730-735. [PMID: 34029167 DOI: 10.1148/radiol.2021192863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
History A 26-year-old man presented with a 1-month history of chest pain, a palpable and painful right inguinal mass, and edema in the right lower extremity. One month earlier, he started to experience left chest pain with no cough. Pulmonary CT angiography (CTA) revealed a left lower lobe segmental pulmonary embolus. The local hospital made a diagnosis of pulmonary embolism. He received anticoagulants, and his chest pain was gradually relieved. At the time of current presentation, the patient was experiencing right lower extremity swelling and pain. Physical examination revealed a 4 × 3 cm palpable right inguinal mass with no redness. His medical history and family history were negative. The results of laboratory work-up were normal, with a d-dimer level of 0.16 mg/L fibrinogen equivalent units (reference range, <0.46 mg/L) and an international normalized ratio of 2.45 (therapeutic range, 2.0-3.0 for a patient taking warfarin), except the prothrombin time was 28.2 seconds (reference range, 9.6-12.8 seconds) and the activated partial thromboplastin time was 52.2 seconds (reference range, 24.8-33.8 seconds). Echocardiography, chest radiography, chest CT, and contrast-enhanced (CE) CT revealed no abnormalities. The patient underwent right lower extremity vascular conventional US (Philips IU22; Philips) with an L9-3 probe (3-9 MHz, venous condition) and contrast-enhanced US (1.5-2.0 mL, SonoVue; Bracco) with an intravenous bolus injection at the initial evaluation. Two days later, noncontrast and contrast-enhanced CT images of the lower abdomen (1.5 mL per kilogram of body weight, 300 mg/mL iomeprol, Iomeron; Bracco) were acquired for further evaluation.
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Affiliation(s)
- Hualin Yan
- From the Departments of Medical Ultrasound (H.Y., C.Z., X.W., Y.L.) and Medical Ultrasound, Laboratory of Ultrasound Imaging Drug (F.Y.), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Chenyun Zhou
- From the Departments of Medical Ultrasound (H.Y., C.Z., X.W., Y.L.) and Medical Ultrasound, Laboratory of Ultrasound Imaging Drug (F.Y.), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Feng Yan
- From the Departments of Medical Ultrasound (H.Y., C.Z., X.W., Y.L.) and Medical Ultrasound, Laboratory of Ultrasound Imaging Drug (F.Y.), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Xiaorong Wen
- From the Departments of Medical Ultrasound (H.Y., C.Z., X.W., Y.L.) and Medical Ultrasound, Laboratory of Ultrasound Imaging Drug (F.Y.), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Yan Luo
- From the Departments of Medical Ultrasound (H.Y., C.Z., X.W., Y.L.) and Medical Ultrasound, Laboratory of Ultrasound Imaging Drug (F.Y.), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
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Cai TY, Loa J. Multimodal imaging demonstrating adventitial cystic disease of the common femoral vein. ANZ J Surg 2020; 91:E330-E331. [PMID: 32997427 DOI: 10.1111/ans.16363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 08/11/2020] [Accepted: 09/15/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Tommy Y Cai
- Department of Vascular Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,School of Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - Jacky Loa
- Department of Vascular Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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