Misleading Presentation: Common Carotid Pseudoaneurysm Mimicking a Cervical Abscess
DOI:
https://doi.org/10.64917/fmcs-009Keywords:
Carotid artery pseudoaneurysm, cervical abscess, neck mass, vascular anomalyAbstract
Background: Pseudoaneurysms of the common carotid artery are rare but potentially life-threatening vascular lesions that can present with nonspecific symptoms. Their clinical presentation may mimic more common conditions such as cervical abscesses, leading to diagnostic delays and inappropriate management.
Case Presentation: We report a case of a 45-year-old male presenting with a painful, progressively enlarging neck mass accompanied by dysphagia and low-grade fever. Initial clinical and radiologic evaluations suggested a cervical abscess. However, further imaging with contrast-enhanced CT and Doppler ultrasound revealed a pseudoaneurysm of the right common carotid artery. Surgical intervention was performed, and the diagnosis was confirmed intraoperatively.
Conclusion: This case underscores the importance of maintaining a high index of suspicion for vascular anomalies in atypical neck masses. Prompt use of appropriate imaging modalities is essential for accurate diagnosis and timely intervention to avoid catastrophic complications.
References
Zbair S, Dinari J, Siwane A, Lezar S, Essodegui F. Pseudo-anévrisme post traumatique de la carotide externe [Post traumatic pseudoaneurysm of the external carotid]. Pan Afr Med J. 2017 Nov 28;28:272. French. doi: 10.11604/pamj.2017.28.272.11259. PMID: 29881512; PMCID: PMC5989190.
Haq TU, Awais M, Rehman A. Angiographic embolization of internal carotid artery pseudo-aneurysm using a covered Jostent and Histoacryl glue. J Neuroradiol. 2016 Dec;43(6):421-423. doi: 10.1016/j.neurad.2016.07.002. Epub 2016 Oct 12. PMID: 27743787.
Law Y, Chan YC, Cheng SW. Endovascular repair of giant traumatic pseudo-aneurysm of the common carotid artery. World J Emerg Med. 2015;6(3):229-32. doi: 10.5847/wjem.j.1920-8642.2015.03.013. PMID: 26401187; PMCID: PMC4566016.
Law Y, Chan YC, Cheng SW. Endovascular repair of giant traumatic pseudo-aneurysm of the common carotid artery. World J Emerg Med. 2015;6(3):229-32. doi: 10.5847/wjem.j.1920-8642.2015.03.013. PMID: 26401187; PMCID: PMC4566016.
Bazina A, Mišmaš A, Hucika Z, Pavliša G, Poljaković Z. Endovascular treatment of internal carotid artery pseudo-aneurysm presenting with epistaxis. A case report. Interv Neuroradiol. 2014 Dec;20(6):743-5. doi: 10.15274/INR-2014-10077. Epub 2014 Dec 5. PMID: 25496685; PMCID: PMC4295247.
Yousuf KM, Khan FH. Pseudoaneurysm of head and neck vessels has been frequently observed in road side bomb blast victims. Surgeon. 2016 Jun;14(3):142-6. doi: 10.1016/j.surge.2014.09.004. Epub 2014 Nov 21. PMID: 25449169.
Brahmbhatt PA, Modi FD, Roy TM, Byrd RP Jr. Common carotid artery laceration and innominate artery pseudo-aneurysm following a percutaneous dilatational tracheostomy attempt. Respir Care. 2014 Oct;59(10):e153-5. doi: 10.4187/respcare.02715. Epub 2014 May 20. PMID: 24847093.
Zhang CG, Chen XY, Wu S, Feng LL, Wang Y, Chen Y, Duan M, Wang K, Song LL. [Internal carotid artery pseudoaneurysm caused by parapharyngeal abscess: A case report]. Beijing Da Xue Xue Bao Yi Xue Ban. 2023 Dec 18;55(6):1135-1138. Chinese. doi: 10.19723/j.issn.1671-167X.2023.06.028. PMID: 38101801; PMCID: PMC10724003.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Dr. Pedro Luis Andrade, MD, Dr. Thulani Dlamini, MBChB, MMed (Radiology)

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain the copyright of their articles published in this journal. All articles are licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited.