0:00

Okay, this is a very rare case.

0:02

This is the only case of this I've seen,

0:05

and I, I, I mean, I didn't read this case, one

0:08

of my colleagues did, but I'm not sure I,

0:10

I didn't know about this entity.

0:11

So let me share with you.

0:12

So this is a patient again, with right

0:16

lower extremity swelling with back in the leg now,

0:19

and there is the cystic area,

0:23

which is apparently adjacent

0:25

or very near the right external iliac vein.

0:29

And it seems like there is very turbulent

0:31

flow right in the vein.

0:33

The, the, um, the velocity is probably fifth,

0:36

at least 50 centimeters per second, which is high.

0:39

And you can see an area of ine right there.

0:43

And so again, when we compare side to side,

0:48

my favorite thing, you can see on the opposite side there is

0:52

good ity,

0:54

but there is diminished ity on the right side.

0:57

So again, it is symmetry

0:59

and we already knew that there was a problem here.

1:01

So what is the cystic area?

1:03

Well, it is a, this is a patient's CT scan

1:07

that shows basically that there is a cystic lesion,

1:11

lower interation lesion in the vein

1:14

or compressing the, um,

1:17

right external iliac vein.

1:19

The other side is normal, okay?

1:22

And so this is a very rare case

1:24

of a cystic advent tissue disease

1:27

of the common femoral vein,

1:29

which basically is a mucin containing cyst in the wall

1:34

of the vein that results in compression of the vein.

1:37

This mucinous containing cyst can, can,

1:40

can occur in the arter as well as the venous system.

1:43

And they're actually more common in the arterial system, uh,

1:46

supposedly in the popliteal artery.

1:48

And what there is, is that accumulation

1:50

of gelatinous fluid in the wall of the vein

1:54

that develops a cyst and causes compression.

1:57

So if it affects the popal artery,

1:59

if the patient will have symptoms of claudication,

2:02

if it affects the vein as in this case you have dampen flu

2:06

and you may even have deep vein thrombosis.

2:08

And the treatment which was offered to this,

2:12

this patient was actually surgical management.

2:15

You have to remove it, um, to, to treat the patient.