PMC6629457_01
Mass in the right cervical area.
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She presented complaining of a mass in the right cervical region (Figure 1), causing pain when she moved her neck, and she was unable to state the time since onset of symptoms.
Doppler ultrasonography showing ectasia, without thrombi in the lumen and normal blood flow.
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At the first consultation, she provided a Doppler ultrasonography scan of the vasculature of the neck (Figure 2), conducted on 25, November, 2016, showing the following: right external jugular vein with segmental ectasia, free from thrombi in the lumen, measuring 3.6 mm at the largest diameter.
Doppler ultrasonography showing hypoechoic mass and thrombosed external jugular vein, with no flow.
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After 1 year of clinical treatment, a Doppler ultrasonography scan was performed on 14 December, 2017 (Figure 3), showing a heterogeneous hypoechoic nodular formation in the upper right cervical area, measuring around 2.4 x 1.5 x 0.9 cm, in the topography of the right external jugular vein, and signs of thrombosis of the external jugular vein.
Angiotomography reconstruction demonstrating the tumoral mass and its relationship with the vascular structures of the neck. CDPI, Barra da Tijuca, RJ, Brazil. AR = area of region of interest in mm2; MD = mean density of region of interest; SD = standard deviation of mean density; Range = density range within region of interest.
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Diagnostic investigation was initiated with angiotomography of the supra-aortic arterial and venous trunks (Figure 4), showing an oval-shaped lesion with the density of soft tissues and regular outline, situated lateral of the mid third of the right sternocleidomastoid muscle, compressing the external jugular vein medially, and measuring approximately 25 x 16 x 10 mm in diameter.
Histopathological examination by the paraffin block method. Hemangioma with thrombosis of the external jugular vein.
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Histological sections (Figure 5) showed fibrous connective tissue with proliferation of small vessels containing red blood cells.