A Rare Presentation of Internal Jugular Vein Swelling: Case Report on Right Internal Jugular Vein Phlebectasia

Abstract

Internal jugular vein (IJV) phlebectasia is a rare, benign venous anomaly characterized by fusiform dilatation of the vessel without tortuosity. It is more frequently reported in children, with adult-onset presentations being uncommon. The condition is often asymptomatic, manifesting as a soft, compressible swelling in the neck that becomes prominent during activities increasing intrathoracic pressure. A case is presented of a 41-year-old man who had an enlarged right-sided neck swelling for 6 months, which became more pronounced during speaking and the Valsalva maneuver. Clinical evaluation and high-resolution ultrasonography with color Doppler were used to evaluate the patient. Sonography revealed fusiform dilatation of the right IJV along its course to the subclavian vein, with a maximal diameter of 15 mm at rest and further dilatation during the Valsalva maneuver. No intraluminal filling defect or cervical lymphadenopathy was observed. Based on clinical and imaging findings, a diagnosis of right IJV phlebectasia was established. Since the patient had no symptoms or problems, the patient was managed conservatively with advice for periodic follow-up. In adults with intermittent neck swelling, this simple vascular anomaly should be considered as a possible causative factor, especially in regions with limited reporting.