Diagnosis and Treatment Strategies for Femoral Vein Extramembranous Cysts: A Case Analysis and Literature Review.
Huan-Huan Song, Wei-Kang Guan, Li Xiang et al.
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Case in brief
A 58-year-old man presented with progressive left-leg swelling and discomfort, with pitting calf edema. Duplex ultrasound showed a hypoechoic cystic lesion compressing the femoral vein; CT and MRI demonstrated a 3.1 cm × 1.4 cm × 2.1 cm mass in the venous adventitia causing partial luminal stenosis, without deep vein thrombosis or evidence of malignancy. Surgery found a translucent adventitial cyst. Complete excision with venous reconstruction was performed, and histopathology confirmed a benign mucin-containing cyst with a single-layer endothelial lining. Symptoms resolved, recovery was uneventful, and there was no recurrence at 3-month follow-up.
What made this case unusual
The lesion arose in the femoral vein adventitia and partially narrowed the lumen, presenting as limb swelling without deep vein thrombosis.
Diagnostic / clinical pearl
In unexplained unilateral limb swelling, consider an adventitial cyst when imaging shows a cystic lesion compressing a vein; multimodal imaging can define its location and distinguish it from other causes of obstruction.