腕神経叢障害を合併したjugular phlebectasiaの1例

A Case of the Jugular Phlebectasia Accompanied by the Brachial Plexopathy: Case Report

Ⅰ．はじめに

　Jugular phlebectasiaは無症候性頚部腫瘤として発見される稀な疾患である．成因としては先天的なanomalyが主体と考えられているが，二次性病変も報告されている^4,5）．臨床的には経過観察されることが多いが，血栓症やHorner症候群などの稀な合併症を生じることもある^3,4）．今回，甲状腺腫瘍摘出術後に二次性のjugular phlebectasiaを呈し，これに腕神経叢障害を合併した症例を経験したので文献的考察を加えて報告する．

　This article reports a case of a 59-year-old male who suffered from left brachial plexopathy occurring at night in bed. He had experienced multiple surgical courses of thyroid tumor resection including neck dissection and had presented left secondary jugular phlebectasia. Jugular phlebectasia is mainly congenital and sometimes secondarily induced by compression, mechanical ventilation, trauma, thrombosis, etc. Brachial plexopathy is usually caused by neck and arm trauma, additionally caused by iatrogenic nerve and vessel injury. To our knowledge, this is the first report of brachial plexopathy accompanied by ipsilateral jugular phlebectasia. We hypothesized the etiology of this case through multimodal examinations and reviewed the literature about jugular phlebectasia and brachial plexopathy.