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British Journal of Oral and Maxillofacial Surgery xxx (2016) xxx–xxx

Letter to the Editor

Venous aneurysm of the facial vein that presented as a

lump in the neck: a case report

Venous aneurysm in the neck is a rare, isolated, saccular,

or fusiform dilatation of a vein of unknown pathogenesis
that most commonly involves the internal jugular vein.1
Inflammation, degeneration, and increased pressure within
the venous system, such as trauma, operation, infection, or
tumours are suspected causes,2 but it can also be congenital.
A 62-year-old woman presented to the oral and maxillofa-
cial unit with a recent, painless, right, submandibular lump.
On examination there was a 2 cm firm mass palpable in the
right submandibular triangle.
Ultrasound (US) showed an 18 x 14 mm lump adjacent
Fig. 2. Ultrasound scan of the submandibular mass.
to the submandibular gland, with no vascularity, but with
the characteristics of a complex cyst. Fine needle aspiration
contained only blood, and computed tomogram (CT) with There have been a few reports of aneurysms of the exter-
contrast confirmed the US findings. nal and internal jugular veins 2,3 that looked vascular when
We excised the lump under general anaesthetic, and scanned, unlike our patient, and this was possibly because of
it looked like a necrotic lymph node. The operation thrombus. An aneurysm was not suspected after radiological
and the postoperative course were uneventful. Histolog- examination, but it seems likely that the aneurysm was from
ical examination showed a dilated vessel that contained her facial vein.
laminated thrombus with fibrosis of the wall, and an ulcer- Two case reports of an idiopathic aneurysm of the facial
ated endothelium, but there was no evidence of a lymph vein have linked this type of aneurysm to chronic sialadenitis
node(Figs. 1 and 2). of the submandibular gland.4,5 This is unlikely to be the cause

Fig. 1. Computed tomogram showing the submandibular mass (blue arrow).

http://dx.doi.org/10.1016/j.bjoms.2016.05.022
0266-4356/© 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Please cite this article in press as: Morton L, Downie I. Venous aneurysm of the facial vein that presented as a lump in the neck: a case
report. Br J Oral Maxillofac Surg (2016), http://dx.doi.org/10.1016/j.bjoms.2016.05.022
YBJOM-4898; No. of Pages 2
ARTICLE IN PRESS
2 Letter to the Editor / British Journal of Oral and Maxillofacial Surgery xxx (2016) xxx–xxx

with our patient as she had no symptoms of sialadenitis and
her submandibular gland showed nothing abnormal on US.
US with Doppler and CT are the gold standard investiga-
tions, and excision remains the treatment of choice for this
rare venous aneurysm.
Conflict of interest
2. Azghari A, Belmir H, Kharroubi A, et al. External jugular vein aneurysm:
a rare cause of neck swelling. A report of three patients. J Mal Vasc
2011;36:395–8.
3. Mohanty D, Jain BK, Garg PK, et al. External jugular venous aneurysm:
a clinical curiosity. J Nat Sci Biol Med 2013;4:223–5.
4. Shekib N, Hakami F. Venous aneurysm of the facial vein. Chest
1978;73:679–80.
5. Ilica AT, Senturk S, Kertmen M, et al. Facial vein aneurysm associated
with sialadenitis. J Clin Ultrasound 2012;40:319–21.

We have no conflicts of interest. Lydia Morton

Ian Downie
Salisbury District Hospital, Odstock Road,
Ethics statement/confirmation of patient permission Salisbury SP2 8BJ, UK
E-mail addresses: lydiamorton@doctors.org.uk
Not applicable in this case. (L. Morton), Ian.downie@salisbury.nhs.uk (I. Downie)

References

1. Battal B, Dursun E. External jugular vein aneurysm: clinical and radio-

logic imaging findings. The Internet Journal of Head and Neck Surgery
2008;Volume 3(Number 1).

Please cite this article in press as: Morton L, Downie I. Venous aneurysm of the facial vein that presented as a lump in the neck: a case
report. Br J Oral Maxillofac Surg (2016), http://dx.doi.org/10.1016/j.bjoms.2016.05.022