Spontaneous external jugular vein pseudoaneurysm: A rare cause of neck swelling

Pseudoaneurysm of the external jugular vein is a relatively unusual cause of a neck mass caused by the low pressure venous system. Regardless of etiology, spontaneous pseudoaneurysms are extremely rare, and only few cases have been described in literature. They require surgery; however, most patients can be safely discharged with close follow-up with a vascular surgeon. This case demonstrates a 30-year-old man who presented with a non-tender, compressible, left-sided neck mass that enlarged with Valsalva, and intermittent paresthesias. Ultrasound confirmed a cystic mass of unknown etiology containing doppler flow suggesting the diagnosis of an external jugular vein pseudoaneurysm, confirmed by a CT angiogrphy. The patient refused the surgery, and we agreed he was safe for discharge at that time and could follow up with vascular surgery as an outpatient.