Doença cística da adventícia na veia basílica: relato de caso
Basilic vein cystic adventitial disease: case report
Rafael Sampaio Vasconcelos, Cesar Augusto Cherubim Filho, Felipe Mavignier Pereira França, Eduardo de Lucca D’allacqua, Marcelo Bellini Dalio, Edwaldo Edner Joviliano
Resumo
A doença cística da adventícia é uma entidade rara que acomete principalmente a artéria poplítea. A ocorrência em veias é muito rara, e sua etiologia é desconhecida. Clinicamente, apresenta-se como isquemia, trombose ou dor a depender do território acometido. Apresentamos o caso de um paciente masculino jovem referindo nódulo no braço esquerdo. A angiorressonância magnética do membro mostrou lesão cística em contato com a veia basílica, com conteúdo homogêneo e sem realce pós-contraste. Foi realizada ressecção da lesão em bloco com o segmento venoso envolvido. O estudo anatomopatológico foi sugestivo de cisto de adventícia de veia basílica.
Palavras-chave
Abstract
Cystic adventitial disease is a rare entity that most often involves the popliteal artery. It rarely occurs in veins. Its etiology is unknown. Clinically, it presents with ischemia, thrombosis or pain, depending on the vessel affected. Here we present the case of a young male with a nodule in the left arm. Magnetic resonance angiography showed a cystic lesion in contact with the basilic vein, with homogenous content without post-contrast enhancement. The lesion was resected en bloc together with the venous segment involved. The results of microscopic analysis were suggestive of basilic vein cystic adventitial disease.
Keywords
References
1. Desy NM, Spinner RJ. The etiology and management of cystic adventitial disease. J Vasc Surg. 2014;60(1):235-45. http://dx.doi.org/10.1016/j.jvs.2014.04.014.
2. Wu X, Jiang B, Lun Y, et al. Venous occlusion due to cystic adventitial degeneration of the common femoral vein. Vasa. 2013;42(6):461-4. http://dx.doi.org/10.1024/0301-1526/a000318. PMid:24220125.
3. Chen Y, Sun R, Shao J, Li Y, Liu C. A contemporary review of venous adventitial cystic disease and three case reports. Phlebology. 2015;30(1):11-6. http://dx.doi.org/10.1177/0268355513516948. PMid:24357449.
4. Lejay A, Ohana M, Delay C, et al. Cystic adventitial pathology as an entity in peripheral arterial disease. J Cardiovasc Surg. 2016;57(2):282-91. PMid:26471959.
5. Nasser M, Pivetta LGA, Teixeira JL Fo, Rocha ES, Botta AE. Critical limb ischemia in a young patient with cystic disease of the popliteal artery. J Vasc Bras. 2012;11(2):144-9. http://dx.doi.org/10.1590/S1677-54492012000200012.
6. Jones DW, Rezayat C, Winchester P, Karwowski JK. Adventitial cystic disease of the femoral vein in a 5-year-old boy mimicking deep venous thrombosis. J Vasc Surg. 2012;55(2):522-4. http://dx.doi.org/10.1016/j.jvs.2011.06.117. PMid:21917399.
7. Kim YK, Chun HJ, Hwang JK, et al. Adventitial cystic disease of the common femoral vein presenting as deep vein thrombosis. Asian J Surg. 2013;23:1-4. PMid:23978427.
8. Dix FP, McDonald M, Obomighie J, et al. Cystic adventitial disease of the femoral vein presenting as deep vein thrombosis: A case report and review of the literature. J Vasc Surg. 2006;44(4):871-4. http://dx.doi.org/10.1016/j.jvs.2006.05.034. PMid:17012010.
9. Morizumi S, Suematsu Y, Gon S, Shimizu T, Iwai T. Adventitial cystic disease of the femoral vein. Ann Vasc Surg. 2010;24(8):1135.e5-7. http://dx.doi.org/10.1016/j.avsg.2010.03.007. PMid:20599347.
10. Albernaz DTS, Albernaz LFL, Eggers EE. Doença cística da artéria poplítea: relato de caso. J Vasc Bras. 2010;9(3):168-72. http://dx.doi.org/10.1590/S1677-54492010000300013.
11. Carrilho C, Mesquita A. Doença cístíca da adventícia da artéria poplítea: diagnóstico e tratamento – a propósito de um caso clínico. Angiol e Cir Vasc. 2013;9(1):1-4.
12. Romiti M, Silvano D. Microembolia por degeneração cística da adventícia da artéria poplítea. Cir Vasc e Angiol. 1991;7(1):14-6.
13. Scott MF, Gavin T, Levin S. Venous cystic adventitial disease presenting as an enlarging groin mass. Ann Vasc Surg. 2014;28(2):489.e15-8. http://dx.doi.org/10.1016/j.avsg.2013.04.019. PMid:24075153.
14. Johnson JM, Kiankhooy A, Bertges DJ, Morris CS. Percutaneous image-guided aspiration and sclerosis of adventitial cystic disease of the femoral vein. Cardiovasc Intervent Radiol. 2009;32(4):812-6. http://dx.doi.org/10.1007/s00270-009-9581-z. PMid:19449068.
15. Kauffman P, Kuzniec S, Sacilotto R, Teivelis MP, Wolosker N, Tachibana A. Doença cística adventicial da artéria poplítea: causa infrequente de claudicação intermitente. Einstein. 2014;12(3):358-60. http://dx.doi.org/10.1590/S1679-45082014RC2818. PMid:25167336.
16. Keo HH, Baumgartner I, Schmidli J, Do D-D. Sustained remission 11 years after percutaneous ultrasound-guided aspiration for cystic adventitial degeneration in the popliteal artery. J Endovasc Ther. 2007;14(2):264-5. http://dx.doi.org/10.1583/1545-1550(2007)14[264:SR YAPU]2.0.CO;2. PMid:17484540.
17. Rai S, Davies RSM, Vohra RK. Failure of endovascular stenting for popliteal cystic disease. Ann Vasc Surg. 2009;23(3):410.e1-5. http://dx.doi.org/10.1016/j.avsg.2008.01.014. PMid:18513486.