Retromandibular venous ectasia presenting as a parotid mass: An interesting case report

Abstract

Introduction: Retromandibular vein ectasia is a rare lesion that is often misdiagnosed and should be considered in the differential diagnosis of neck masses. An accurate radiological diagnosis can avoid unnecessary invasive procedures.

Presentation of case: A 63-year-old patient presented with positional, left parotid swelling, whose ultrasound and magnetic resonance angiography indicated retromandibular vein ectasia. Therefore, no intervention or follow-up was needed for the lesion because it was asymptomatic.

Discussion: Retromandibular venous ectasia is an unusual focal dilatation of the retromandibular vein that occurs without thrombosis or obstruction of the proximal veins. They may present as an intermittent swelling of the neck, which is triggered by the Valsalva maneuver. Contrast-enhanced MRI is the preferred imaging modality for diagnosis, interventional planning, and evaluation of post-therapeutic efficacy. Conservative or surgical management depends on clinical symptomatology.

Conclusion: Retromandibular vein ectasia is a rare and generally misdiagnosed condition. It should be considered in the differential diagnosis of neck masses. Appropriate radiological investigation allows early diagnosis and prevents unnecessary invasive. Management is conservative in the absence of significant symptoms and risks.

Keywords: Parotid gland; Retromandibular venous ectasia; Varix.