Presentation
Swollen left leg.
Patient Data
Ovoid non-enhancing lesion arising within close proximity to the posterior margin of the left common femoral vein.
Incidental large right posterior bladder diverticulum, hiatal hernia, and partially calcific cyst in the left kidney.
Ovoid shaped non-enhancing high T2, low T1 signal focus is in close relation to the left common femoral vein. This is noted to cause marked effacement of the vein. There is stranding of the subjacent tissue, with non-enlarged prominent nodes present in the left groin.
Subcutaneous edema is extending from the left groin to the anterior aspect of the upper thigh imaged. No organized collection.
Bladder diverticulum.
The patient underwent a resection of the cystic common femoral vein lesion and subsequent venous reconstruction.
Histology:
Left common femoral vein: The sections show a large vein. Focal myxoid degeneration of the adventitia seen. Hemosiderin deposition and focal occasional stromal giant cell is seen adjacent to this focus. No other significant pathological features noted. The histological changes present would be compatible with the clinical impression of cystic adventitial disease of the common femoral vein.
Case Discussion
Cystic adventitial disease is mucinous accumulation in the vascular adventitia. It is rare, usually unilateral, and usually arterial. Rarely, as in this case, it can arise from the adventitia of a vein.
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