case_images: PMC11177842_01
case_images: Preoperative imaging of internal jugular venous malformation. (A) Coronal view of computerized tomographic scan. (B) Axial view of computerized tomographic scan. (C) Magnetic resonance imaging showing hyperintensity of lesion in T2.
case_images: mdcvj-20-1-1336-g1.jpg
case_images: PMC11177842_01_mdcvj-20-1-1336-g1.jpg
case_images: F1
case_images: The CT scan (Figure 1A, B) demonstrated a well-defined left carotid sheath mass that was concerning for a possible schwannoma or lymph node enlargement. T2 (Figure 1C) and had homogenous enhancement with contrast injection; in addition, it showed that the mass remained inseparable from the ventral surface of the left internal jugular vein. The differential diagnosis at this point was a venolymphatic malformation.
case_images: Surgical excision of internal jugular venous malformation. (A) Venous malformation adherent to internal jugular vein. (B) Excision of malformation. (C) Partial resection internal jugular vein. (D) Ligation of internal jugular vein stumps.
case_images: mdcvj-20-1-1336-g2.jpg
case_images: PMC11177842_01_mdcvj-20-1-1336-g2.jpg
case_images: F2
case_images: IJVM (Figure 2A). It was noted to be highly friable and vascularized. The mass was then resected and sent to pathology (Figure 2B). Since the patency of the contralateral IJV was confirmed in the patient's CT scan, the decision was made to resect the portion of the vein that was in contact with the mass (Figure 2C). Hemostasis was achieved using electrocautery and hemoblast, and the wound was closed in layers (Figure 2D).
case_images: Histopathology analysis of resected lesion (40x magnification). (A) H&E stain of vascular malformation. (B) Immunohistochemical stain highlighting endothelial cells of vascular malformation. (C) H&E stain of left internal jugular vein.
case_images: mdcvj-20-1-1336-g3.jpg
case_images: PMC11177842_01_mdcvj-20-1-1336-g3.jpg
case_images: F3
case_images: Pathologic evaluation demonstrated a vascular malformation associated with a medium-sized venous malformation (Figure 3A-C).