Management of external jugular vein aneurysm: a systematic review

Abstract

Introduction Aneurysms of the jugular vein system are rare and high clinical suspicion is needed for diagnosis. External jugular vein aneurysms (EJVA) are considered innocent lesions that need treatment mainly for aesthetic reasons. The aim of this systematic review was to present current literature regarding diagnosis and management of EJVAs. Methods A literature review was conducted through the Pubmed/Medline and Scopus regarding articles referring on EJVA from 2000 to 2020. Using the PRISMA guidelines (Preferred Reporting Items for Systematic reviews and Meta-Analyses), 30 articles were identified, according to inclusion criteria. Demographics, clinical characteristics, etiology, diagnostic imaging, complications, treatment, and histopathological findings were recorded and analyzed. Results Twenty-seven case reports and one case series were identified, including 30 patients and 31 EJVAs. One-third of patients (30.3%) were < 18 years old (mean age 32 years, range 1–72 years) and 54% of them were females. In 51% of the cases, the lesion was characterized as a true aneurysm after histological evaluation. The presence of a soft cervical mass was the most common clinical symptom, while Valsalva maneuver pointed out the presence of an EJVA in 66.7% of patients. Diagnosis was achieved using ultrasonography, computed tomography, or magnetic resonance imaging. Forty-three percent of the patients underwent more than one radiological examination. Twenty patients underwent surgical management. The primary indication of surgical treatment was aesthetic reasons (11/20, 55%). Thrombosis was the most common EJVA complication (11/30, 36.3%). Conclusions Differential diagnosis of neck mass should include EJVA. High clinical suspicion and adequate imaging are important for diagnosis. Open surgical approach is the more commonly applied therapeutic strategy.

External Jugular Venous Aneurysm: A Case Report

“…There have been no reports of serious complications associated with venous aneurysms in the head and neck region, including the internal jugular vein. 2 Surgical resections of EJV aneurysms (whether primary or acquired) are the treatment of choice even though life-threatening complications are not reported. 2 A few reports have described embolization treatment for EJV aneurysms, however.…”

“… 2 Surgical resections of EJV aneurysms (whether primary or acquired) are the treatment of choice even though life-threatening complications are not reported. 2 A few reports have described embolization treatment for EJV aneurysms, however. 10 Indications for treatment are primarily cosmetic and may be due to pain or other symptoms.…”

“…Venous aneurysms in the neck are rarely encountered in clinical practice due to the low blood pressure in the superior vena cava. [1][2][3] Internal jugular veins are most commonly affected, followed by EJV and anterior jugular veins. 4 There are two types of venous aneurysms: primary and acquired.…”

“… 1 During the 21-year period from 2000 to 2020, only 30 cases have been reported. 2 EJV aneurysms are considered innocent lesions that require treatment mainly for aesthetic reasons, and an open surgical approach is the more commonly applied therapeutic strategy. 2 A thrombus within the lumen rarely results in a pulmonary embolism, but surgery is performed to alleviate pain or improve cosmetic appearance.…”

“… 2 EJV aneurysms are considered innocent lesions that require treatment mainly for aesthetic reasons, and an open surgical approach is the more commonly applied therapeutic strategy. 2 A thrombus within the lumen rarely results in a pulmonary embolism, but surgery is performed to alleviate pain or improve cosmetic appearance. In most cases, the EJV aneurysms are treated by otolaryngologists or vascular surgeons.…”