Aneurisma de vena facial

Summary. Introduction. Aneurysms of the facial vein (FV) are rare. Only five cases have been reported in the literature. Here, we report the case of a patient with acute thrombosis of a giant aneurysm in the left FV, which was treated by means of surgical resection. Case report. Our case involved a 70-year-old female with a painful tumour that was neither compressible nor pulsatile in the left side of her neck. The computerised tomography (CT) scan showed a 4 x 4 cm mass, with no contrast enhancement, lying adjacent to the internal jugular vein. The thrombosed aneurysm was excised from the FV with ligation of the proximal and distal ends. No perioperative complications occurred. Conclusions. The mean age at which aneurysms of the FV appear is 36 years (interval: 11-70 years) and there is a slight predominance in males. They are usually located in the anterior branch of the vein and half the cases are congenital. Pain is the most frequent symptom and the average size is almost 4 cm. No thromboembolic complications have been reported. Diagnostic imaging is performed with ultrasonography, CT and magnetic resonance scanning. Treatment is indicated for symptomatic or large-sized cases. Special care must be taken in those that are located in the retromandibular branch, due to its being in close contact with the parotid and the facial nerve. Differential diagnosis is carried out with cysts, laryngoceles and neck tumours. [ANGIOLOGÍA 2008; 60: 229-32]