Internal jugular vein (IJV) ectasia is a rare benign disease. It commonly presents as a unilateral, soft, compressible neck swelling that mostly involves the right side. It is usually a childhood disease and believed to be of congenital origin. Accurate diagnosis from careful history, physical examination and radiological study can be made. We report here two cases of IJV ectasia in African adults with right lateral neck mass dilating when increase intrathoracic pressure. Because of its rarity, this entity is frequently ignored or misdiagnosed. This case report intends to stress the importance of keeping IJV ectasia as differential diagnosis in mind in case of lateral neck swellings to avoid invasive investigations and inappropriate treatment. The asymptomatic case management of IJV ectasia is conservative with long-term surveillance.
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