Surgically managed paediatric external jugular vein pseudoaneurysm

Aneurysms and pseudoaneurysms predominantly affect the high-pressure arterial system; venous manifestations are exceedingly rare. While the internal jugular vein is the most common cervical site—typically following catheterisation—external jugular vein (EJV) pseudoaneurysms are far less common. Although usually managed conservatively, surgery may be indicated in select cases.

A preteen girl presented with a 3-month history of a painless, compressible, right-sided neck mass that enlarged during the Valsalva manoeuvre. There was no history of trauma.

Sonographic evaluation demonstrated focal EJV dilatation (3.1 cm×0.9 cm) with peripheral echogenic components. Contrast-enhanced CT confirmed a 2.5 cm×1.7 cm×2.5 cm enhancing saccular mass with vascular continuity to the EJV.

Surgical excision was performed. Histopathology revealed dilated vascular channels with organising thrombi and recanalisation, consistent with the diagnosis.

Despite the rarity, EJV pseudoaneurysms should be included in the differential diagnosis of paediatric neck masses.