Abstract

Extracranial carotid artery aneurysms (CAAs) are exceedingly rare, accounting for less than 1% of all peripheral arterial aneurysms, with true aneurysms of the internal carotid artery (ICA) being particularly uncommon. We describe the case of a 57-year-old female who presented with a pulsatile right-sided cervical mass. Imaging studies, including ultrasonography, computed tomography angiography, and magnetic resonance angiography, identified a true saccular aneurysm of the proximal right ICA measuring approximately 2.5 cm. Due to unfavorable tortuous anatomy, endovascular treatment was not feasible. The patient underwent open surgical excision of the aneurysmal segment with primary end-to-end anastomosis. Her postoperative recovery was uneventful, with no neurological complications, and she remained asymptomatic at 3-month follow-up. This case highlights that although rare, true ICA aneurysms carry clinically significant risks, and open surgical reconstruction remains a safe and effective treatment option when endovascular approaches are unsuitable.

Key words: Extracranial carotid artery aneurysm, neck mass, surgical repair