Unusual incidental finding in the staging of a T1a-glottic carcinoma

Introduction:

The recognition of cervical masses of the neck is through the combination of several imaging procedures already preoperatively very well possible. Rarely the entity of the lesion is only during surgery certainly differentiable. The following case report shows a rare additional finding, that was during staging of a glottis carcinoma not structurally differentiable. It was only identified as jugular vein aneurysm during surgery.

Case Description:

A 68-year-old patient complains of hoarseness without B symptoms, dysphagia and dyspnea. In panendoscopy with sampling and subsequent laser resection, a laryngeal carcinoma on the right pT1a pN0c M0 G1 was diagnosed. While performing staging examinations a suspicious supraclavicular mass (level IV) was found in computer tomography of the neck/thorax on the left side. In the sonography no typical lymph node could be diagnosed, but a hypoechoic mass, with wall structure and hyperechoic, partially moved material without a sure Doppler sonographic flow signal could be detected. Because an esophageal diverticulum was suspected, a barium swallow was performed in which a diverticulum has been ruled out. Intraoperatively, an aneurysmal outgrowth from the venous angle of the internal jugular vein and the subclavian vein could be identified.

Conclusion:

The jugular venous aneurysm is a rarity among the venous diseases. Its significance in the context of unclear neck swelling and the clinical findings will be presented, as well as diagnostic methods, treatment and possible complications in review of current literature.

Publication History

Publication Date:
23 April 2019 (online)