A rare cause of pulmonary embolism: the popliteal vein aneurysm

CASE DESCRIPTION A 68 years old woman was admitted in our Hospital because of a pulmonary embolism. She was successfully treated with thrombolysis. The physical examination revealed the presence of a palpable mass in the popliteal region, evident in orthostatic position, disappearing in supine position. The ultrasonography showed a pathologic dilatation (venous aneurysm) of the popliteal vein, 5 — 7 mm, partially thrombosed.
DISCUSSION Popliteal vein aneurysm is a rare condition, 126 cases in scientific literature, usually described after an episode of pulmonary embolism or as an accidental finding. It is defined as a dilatation of the popliteal vein twice the normal diameter (McDevitt) or at least 20 mm, according to Maleti. Pathogenesis is uncertain, probably related to constitutional factors or post-traumatic. The risk of embolization is high (45% of described cases) and surgery (aneurysmectomy with venorraphy or venous graft) is usually necessary in embolizing cases. Anticoagulation is always mandatory, and careful clinical surveillance, in all non surgical cases.