Jugular venous ectasia can mimic a cystic hygroma—Potential risk from sclerotherapy

Abstract

Summary Objectives: To recognize the similarities between cervical cystic hygromas and ectasias of the anterior jugular vein and the differences in their management. Study design: Observational. Setting: Tertiary children' medical center. Interventions: Computed tomography, Doppler ultrasonography, magnetic resonance imaging, surgical excision, pathologic correlation. Results: A 5-year-old girl presented with a soft, bluish, non-tender neck mass that fluctuated in size. It was studied by color-flow Doppler ultrasonography, computed tomography, magnetic resonance imaging and histology. Ultrasonography revealed a solitary cystic lesion with a solid component and no evidence of blood flow. Computed tomography failed to demonstrate the lesion. Magnetic resonance imaging showed a fluid filled lesion with a solid component. The lesion was thought most consistent with a cystic hygroma. Sclerotherapy was considered, but surgical resection was ultimately elected. The lesion proved to be a vascular ectasia of the anterior jugular vein containing a thrombus. Conclusions: Sclerotherapy has been proposed as an alternative treatment for cystic hygromas. Care must be taken in the choice of this therapy and its application for a lesion lacking histologic confirmation prior to therapy.