True Aneurysm of Superficial Temporal Artery Presenting as Subcutaneous Scalp Swelling: A Diagnostic Conundrum in Two Cases

Abstract

True aneurysms of the superficial temporal artery (STA) are very rarely encountered in clinical practice. Unlike pseudoaneurysms neither they have any preceding history of trauma nor are they associated with atherosclerosis or any other comorbid conditions. We hereby report two such cases, which according to our literature search are exceedingly rare. Two young patients presented with subcutaneous swelling of short duration in the scalp. They did not have any prior history of trauma or associated comorbidities. The only presenting symptom was headache with a pulsatile subcutaneous mass. Diagnostic workup revealed STA aneurysm in both the cases and they were managed with surgical excision of the aneurysm. Histopathology of the aneurysm wall revealed true aneurysm in both cases. True aneurysms of STA should be considered a differential diagnosis in patients with a scalp swelling along the course of the artery. Younger patients should be investigated further to look for any congenital predisposition or coexistent vascular lesion. Considering that it is a rare entity, a proper investigating protocol and surgery remains the key to their successful management.