Meng XH, Liu YC, Xie LS, Huang CP, Xie XP, Fang X. Intravascular fasciitis involving the external jugular vein and subclavian vein: A case report . World J Clin Cases 2022; 10(3): 985-991 [PMID: 35127911 DOI: 10.12998/wjcc.v10.i3.985]
Corresponding Author of This Article
Xin Fang, MAMS, Chief Physician, Department of Vascular Surgery, The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No. 261 Huansha Road, Hangzhou 310006, Zhejiang Province, China. fangxin19800324@163.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Xiao-Hu Meng, Yong-Chang Liu, Xu-Pin Xie, Xin Fang, Department of Vascular Surgery, The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Le-Si Xie, Department of Pathology, The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Chang-Pin Huang, Department of General Surgery, Hangzhou Geriatrics Hospital, Hangzhou 31006, Zhejiang Province, China
Author contributions: Meng XH contributed to the study conception and writing; Meng XH and Fang X contributed to the data collection and investigation; Meng XH and Xie LS contributed to the analysis; all authors contributed to the critical review and revision, final approval of the article and accountability for all aspects of the work.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report. A copy of the written consent is available for review from the Editor-in-Chief of this journal.
Conflict-of-interest statement: All authors have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin Fang, MAMS, Chief Physician, Department of Vascular Surgery, The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No. 261 Huansha Road, Hangzhou 310006, Zhejiang Province, China. fangxin19800324@163.com
Received: November 14, 2020 Peer-review started: November 14, 2020 First decision: July 16, 2021 Revised: July 26, 2021 Accepted: December 22, 2021 Article in press: December 22, 2021 Published online: January 21, 2022
Abstract
BACKGROUND
Intravascular fasciitis (IVF) is a rare nodular fasciitis that often involves the layers and lumens of blood vessels; therefore, it is easily misdiagnosed as a malignant tumor with invasion into blood vessels.
CASE SUMMARY
A 13-year-old boy was admitted due to a mass on the left side of his neck. Duplex ultrasonography revealed a circular solid hypoechoic mass in the external jugular vein, and magnetic resonance imaging revealed an enhanced longitudinal mass-like lesion in the left supraclavicular fossa. Surgical treatment was arranged and completed, histopathological analysis showed a large amount of spindle cell proliferation, and immunohistochemistry showed that the spindle cells were positive for the expression of vimentin, caldesmon, and smooth muscle actin and negative for the expression of S-100 protein, desmin, CD34, and c-kit; Ki-67 staining revealed a low proliferative index (5%-10%), which confirmed the differentiation characteristics of myofibroblasts. Fluorescence in situ hybridization detected the rearrangement of USP6. IVF was subsequently diagnosed.
CONCLUSION
IVF is characterized by intraluminal, intramural and extramural involvement of small to large arteries or veins. Unless the doctor has a deep understanding of the disease or suspects that there is an initial indicator, IVF may be confused with other intravascular malignancies, leading to unnecessary radical surgery. Imaging examination combined with histopathological examination can improve the diagnostic accuracy of this disease.
Core Tip: Intravascular fasciitis (IVF) is a rare vascular-associated nodular fasciitis that is easily misdiagnosed as other tumors. We report a case of this rare disease and provide insights on IVF, with the hope of improving the recognition of non-neoplastic lesions to avoid misdiagnosis.
