Giant primary great saphenous vein aneurysm

A 60-year-old female presented with a chief complaint of left inguinal bulging for over 40 years, which had increased significantly in the past ten months. The patient reported no prior history of trauma, deep vein thrombosis, or arteriovenous malformation. Physical examination revealed a tender, non-pulsatile left groin mass that enlarged markedly during the Valsalva maneuver. (Figure A) The remaining portion of the left great saphenous vein (GSV) was normal in caliber, with no incompetent perforating veins or varicosities identified.