Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2017; 5(12): 419-422
Published online Dec 16, 2017. doi: 10.12998/wjcc.v5.i12.419
Surgical resection of rare internal jugular vein aneurysm in neurofibromatosis type 1
Khortnal Delvecchio, Fazaldin Moghul, Bipinchandra Patel, Susan Seman
Khortnal Delvecchio, Fazaldin Moghul, Bipinchandra Patel, Department of Surgery, Detroit Medical Center Huron Valley-Sinai Hospital, Commerce, MI 48382, United States
Khortnal Delvecchio, Fazaldin Moghul, Bipinchandra Patel, Susan Seman, Department of Surgery, Detroit Medical Center Sinai Grace Hospital, Detroit, MI 48235, United States
Author contributions: Delvecchio K, Moghul F and Patel B examined patient and collected clinical data; Moghul F and Patel B performed surgical resection and follow up; Delvecchio K and Moghul F wrote the paper; Patel B and Seman S edited the manuscript and had final approval.
Institutional review board statement: The authors’ institution does not require IRB approval to publish a single case report.
Informed consent statement: Informed written consent was obtained from the patient prior to all procedures described in the report as well as for the use of the patient’s clinical information and images for published scientific works.
Conflict-of-interest statement: All of the authors report no relationships that could be construed as a conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Khortnal Delvecchio, DO, General Surgery Resident, Department of Surgery, Detroit Medical Center Sinai Grace Hospital, Room M5H02, 6071 W. Outer Drive, Detroit, MI 48235, United States. kdelvecc@dmc.org
Telephone: +1-248-7906442 Fax: +1-313-9664204
Received: February 26, 2017
Peer-review started: March 2, 2017
First decision: May 23, 2017
Revised: September 10, 2017
Accepted: November 22, 2017
Article in press: November 22, 2017
Published online: December 16, 2017
Processing time: 284 Days and 3.9 Hours
Abstract

Neurofibromatosis type 1 is a congenital condition affecting neurons and connective tissue integrity including vasculature. On extremely rare occasions these patients present with venous aneurysms affecting the internal jugular vein. If they become large enough there presents a risk of rupture, thrombosis, embolization or compression of adjacent structures. In these circumstances, or when the patient becomes symptomatic, surgical exploration is warranted. We present a case of one of the largest aneurysms in the literature and one of only five associated with Neurofibromatosis type 1. A 63-year-old female who initially presented for a Hinchey III diverticulitis requiring laparotomy developed an incidentally discovered left neck swelling prior to discharge. After nonspecific clinical exam findings, imaging identified a thrombosed internal jugular vein aneurysm. Due to the risks associated with the particularly large size of our patient’s aneurysm, our patient underwent surgical exploration with ligation and excision. Although several techniques have been reported, for similar presentations, we recommend this technique.

Keywords: Internal jugular, Venous aneurysm, Ligation, Neurofibromatosis 1, Excision, Resection

Core tip: Neurofibromatosis type 1 is a congenital condition occasionally affecting vascular connective tissue integrity. On extremely rare occasions these patients present with internal jugular venous aneurysms. We present a case of the successful ligation and excision of one of the largest internal jugular vein aneurysms in the literature and one of only five associated with Neurofibromatosis type 1.