Idiopathic pseudoaneurysm: a rare cause of parotid mass

Abstract

A 77-year-old woman presented with a pulsatile blue-tinged mass over the left parotid, present for 5 years, and slowly enlarging. The size of the mass fluctuated during this period and there was no associated pain. The patient reported no history of surgery or trauma. Vascular lesions are rarely encountered within parotid glands in adults. MRI with contrast demonstrated a soft tissue lesion; despite the presence of feeding vessels it was thought unlikely to be an arterial venous malformation or aneurysmal change. The appearance was thought to be in keeping with an enlarged lymph node or sebaceous cyst. Fine-needle aspiration was obtained using ultrasound guidance and yielded bloody fluid. The lesion was closely related to the superficial temporal artery and a diagnosis of a thrombosed pseudoaneurysm was made. The vessel had thrombosed and the decision was made to enact a watchful waiting policy. The patient will be monitored in the outpatient setting.

Seltene Erkrankungen der Speicheldrüsen und des Nervus Facialis

“…Imaging by means of sonography or ultrasound reveals an inconspicuous gland displaced externally, mostly caused by a medially located mass. In the literature, case reports of aneurysms and pseudo-aneurysms of the internal and external carotid arteries and their branches are described that become apparent due to a unilateral swelling in the jaw angle 162 164 165 166 . Interestingly, also 2 cases have been reported where aneurysm of the superficial temporal artery after parotidectomy has developed 167 168 .…”

“…In der Literatur werden Fallberichte von Aneurysmen und Pseudoaneurysmen der A. carotis interna oder A. carotis externa bzw. ihrer Äste beschrieben, die durch eine einseitige Schwellung im Kieferwinkel aufgefallen sind 162 164 165 166 . Interessanterweise wurden auch 2 Fälle beschrieben, in denen ein Aneurysma der A. temporalis superficials nach einer Parotidektomie entstanden ist 167 168 .…”