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Cervical aortic arch: an unusual cause of a pulsatile neck mass
  1. Lloyd Steele,
  2. Benjamin Silver,
  3. Issa Beegun,
  4. Hesham Saleh
  1. Department of ENT, Imperial College Healthcare NHS Trust, London, UK
  1. Correspondence to Dr Lloyd Steele, lloyd.steele{at}


A 72-year-old man presented with epistaxis on two occasions requiring admission. Prior to performing a bilateral sphenopalatine artery ligation diathermy, anaesthetic concern was raised regarding what the patient described as a ‘congenital aortic aneurysm’, with an overlying scar secondary to explorative surgery as a child. The abnormality was a cervical aortic arch (CAA). CAA is a rare vascular anomaly, which most commonly manifests as a pulsatile neck mass. In this case, we discuss the differential diagnosis for a pulsatile neck mass and considerations to be made in the workup. We also highlight the importance of cardiovascular risk factor management in patients with CAA.

  • ear, nose and throat/otolaryngology
  • vascular surgery
  • otolaryngology / ent
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  • Contributors LS was involved in the clinical team managing the patient and drafted the manuscript. BS, IB and HS were involved in the clinical team managing the patient and critically reviewed the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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