J Korean Foot Ankle Soc.  2024 Mar;28(1):27-30. 10.14193/jkfas.2024.28.1.27.

Multiple Aneurysms with Thrombosis on the Small Saphenous Vein

• Kang C
• Song JH
• Won Y
• Tan EW
• Lee GS

• KMID: 2553806
• DOI: http://doi.org/10.14193/jkfas.2024.28.1.27

Abstract

Several types of soft tissue masses occur in the lower extremities. A mass associated with blood vessels is often difficult to diagnose. A 15-year-old male patient visited the author’s hospital with discomfort and edema in his right calf that had persisted for six months. A physical examination showed no palpable mass other than mild edema. Three masses were found during the ultrasound scan along the small saphenous vein. The masses had a cyst-like appearance and were filled with thrombus. In duplex ultrasound, vascular reflux was represented inside the masses. During surgery, it was suspected that vascular deformation occurred in the small saphenous vein, and simple ligation and resection treatments were performed. The patient was finally diagnosed with venous aneurysms accompanied by thrombosis based on the histology tests. The symptoms disappeared after surgery, and there were no recurrences or unusual findings at the follow-up one year later. Venous aneurysms occurring in the superficial veins of the lower extremities are rarely reported, but treatment and diagnosis are important. This paper reports a case of an aneurysm on the small saphenous vein.

Keyword

Lower extremity; Saphenous vein; Cyst; Thrombosis; Ultrasonography

Figure

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  Figure 1 The ultrasound images of the right small saphenous vein. (A) In the short axis view, the vein is dilated as fusiform shape aneurysm containing thrombus. (B) In the long axis view, blood vessel is dilated about twice as much as the normal areas above and below. (C) Duplex ultrasound scan showing venous reflux in the aneurysm.

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  Figure 2 The magnetic resonance imaging images. (A) T1-weighted axial, (B) T2-weighted longitudinal, (C, D) T1-weighted enhanced axial and longitudinal images show the dilatation and thrombus along the small saphenous vein.

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  Figure 3 The gross photo images. (A) Venous aneurysms are marked on the posterior calf by using ultrasound in the operation room. (B) These tissues are the proximal (arrow) and distal (arrowhead) aneurysms after aneurysmectomy.

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