Vein aneurysms represent a rare clinical entity with a wide range of clinical symptoms. We present a case of a 67-year-old male who presented with a large, bluish, easily compressible, soft tissue mass in the lateral side of his forearm, which was mildly tender and it had been worsening during the last year. A color duplex ultrasound revealed local venous dilatation of the cephalic vein, measuring 6.3 × 3.2 cm. The patient was operated under local anesthesia and the lesion was removed. Histology showed thinning of the inner and middle layers of the cephalic vein and incipient replacement of the outer layer by acellular fibrous tissue with progressive decrease of elastic, smooth muscle and collagen fibers of the inner and middle layers, compatible with an aneurysm of the cephalic vein. Large cephalic vein aneurysms might cause nerve compression and require surgical removal before permanent neurological defect occurs.
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