Intravascular papillary endothelial hyperplasia (IPEH) is a benign lesion of vascular origin characterized by excessive proliferation of endothelial cells in normal blood vessels or aneurysms. A 51-year-old woman presented with a hard pulsatile mass in the left antecubital fossa. Duplex scan imaging revealed a brachial artery aneurysm with intramural thrombus. At surgery, the aneurysm was resected, and the brachio-radio-ulnar artery was bypassed with a saphenous vein graft. Histopathologic examination revealed papillary endothelial hyperplasia with features of epithelioid hemangioma. We present the first reported case of IPEH associated with a brachial artery aneurysm.
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