Unilateral anterior jugular phlebectasia

Abstract

We present a rare case of unilateral anterior jugular venous phlebectasia in an 82-year-old female patient presenting as a soft cystic lump in the anterior aspect of the neck increasing in size during straining and valsalva manoeuvre. Although cases of internal and external jugular phlebectasia have been reported, as far as we are aware no case of anterior jugular phlebectasia has been reported in the literature previously.

Unilateral Jugular Vein Phlebectasia

“…3 The cases of jugular phlebectasia describe no etiology or complications due to this lesion. [1][2][3] In our case, the phlebectasia occurred after carrying a bag straining his neck. Our hypothesis is that the strap of the bag compressed the outflow into the brachiocephalic vein, which caused a temporary increase of pressure in the aberrant branch of the jugular vein resulting in a dilatation.…”

Phlebectasia of left anterior jugular vein

“…The diagnosis can be made on a clinical basis and confirmed by the non-invasive imaging of Doppler ultrasound and/or computed tomography. They are the preferred methods of investigation that should show an echo-free space and the size of the vein, that changes and extends on the Valsalva manoeuvre (Zohar et al, 1989;Walsh et al, 1992;Natarajan et al, 1994). The chance of thrombosis arising in a dilated jugular vein should not be higher than the normal side.…”

“…No treatment is necessary for anterior jugular vein phlebectasia, except in those cases where cosmetic defects or symptoms develop, or the diagnosis is uncertain. For them, simple surgical excision of the anterior jugular vein is all that is required (Zohar et al, 1989;Natarajan et al, 1994).…”

“…Internal jugular phlebectasia is the most common form, while external, anterior jugular and posterior facial phlebectasias are uncommon. Although jugular phlebectasia might rarely be bilateral, it is mostly unilateral and the right side is affected more than the left (Bowdler and Singh, 1986;Natarajan et al, 1994;Al-Dousary, 1997). Only two cases of anterior jugular vein phlebectasia, which were in the right neck, have been published in the medical literature (Zohar et al, 1989;Natarajan et al, 1994).…”

Jugular phlebectasia presenting as globus pharyngeus

“…Internal jugular phlebectasia is the most common form, while external, anterior jugular and posterior facial phlebectasias are uncommon [9]. Only 2 cases of right anterior jugular vein phlebectasia have been reported [7,10] and non presenting as a globus pharyngeus.…”