Venous Ectasia of Retromandibular and Common Facial Veins: A Rare Clinical Entity

Abstract

Venous ectasias are benign conditions of the neck, in which focal dilatations of veins occur. Internal jugular, external jugular or superficial veins are usually the affected ones in the neck. They are often ignored or misdiagnosed. Here we are reporting a patient with venous ectasia of the retromandibular vein and the common facial vein. A 25-year-old male presented to our out-patient department with an intermittent swelling over the right side of the neck that he had for one year. The swelling was more prominent on lying down and on Valsalva maneuver. Radiologic imaging was suggestive of venous ectasia of the retromandibu-lar vein and the common facial vein. Surgical excision was done for aesthetic reasons and in fear of thrombosis. Intraoperatively, we noticed that it was arising from the retromandibular and the common facial veins. Venous ectasias of superficial veins are rare. We can consider these patients for surgical excision in view of the risk of thrombosis, thromboembolic events, rupture, and aesthetic reasons.

Idiopathic Facial Vein Aneurysm: A Case Report and Review of the Literature

“…Venous aneurysms in the head and neck are uncommon, and involvement of the facial vein is exceedingly rare, with only a few cases described in the literature (Table 1) [2,[5][6][7][8][9][10]. They are typically benign and may present with transient enlargement during movements that increase intrathoracic pressure or impede venous return.…”

Retromandibular vein ectasia : A parotid mass mimicker

“…Vascular malformations are classified as low-flow malformations (capillaries, veins, and lymphatic vessels), high-flow malformations (arterial malformations, arteriovenous malformations, and arteriovenous fistulas), and combined malformations (venolymphatic malformations) [3] . According to this classification, retromandibular venous ectasia is considered a low-flow vascular malformation [5] . It is extremely rare with a limited number of case reports in the literature [1] .…”

“…Cervical venous ectasias usually have a benign course and are generally asymptomatic [5] . They may present with an intermittent neck swelling, enlarged by the Valsalva maneuver, easily compressible, with no palpable thrill [6] .…”

“…Retromandibular vein ectasia's differential diagnosis includes soft neck masses: parotid masses, lymph nodes, lymphangiomas, branchial cysts, cystic hygromas, hemangiomas, laryngoceles, and thyroglossal duct cysts … [5] . It is important to differentiate between venous malformations and soft neck masses to prevent unnecessary invasive procedures [2] .…”

“…Imaging is the key to diagnosis [5] . Doppler ultrasound combined with the Valsalva maneuver is the first modality of investigation.…”