Idiopathic external jugular vein thrombosis

Idiopathic external jugular vein (EJV) thrombosis is a very rare condition. EJV thrombosis usually develops as a result of injury, intravenous cannulation, intravenous injections, inflammatory and malignant tumours of the neck or haematologic diseases. This article presents a case of a 29-year-old otherwise healthy male admitted to the Department with left EJV thrombosis manifesting as a new onset of swelling of the left cheek and side of the neck which he noticed upon awakening in the morning. The oedema resolved spontaneously a few hours later. Clinical examination only revealed a mild bulge in the left supraclavicular area. Doppler ultrasound (DUS) and computed tomography angiography (CTA) revealed an oval, heterogeneous mass with a smooth contour and well-circumscribed margins within the terminal segment of the left EJV, adjacent to the vascular wall. The mass did not occlude the vessel completely, but only caused its significant dilatation above the lesion, and diagnostic imaging could not unequivocally exclude a tumour. Therefore, the patient underwent surgery whereby the diseased part of the EJV was removed. The histologic evaluation confirmed a typical structure of a thrombus. The postoperative course was uneventful. To date, over the 4-year follow-up, there was no recurrence confirmed either clinically or in duplex US. The case has been discussed in the context of the available literature.