Introduction:

Non-traumatic superficial temporal artery (STA) aneurysms are extremely rare, constituting about 8% of all STA aneurysms. They usually present as a pulsatile mass in the temporal or parietal region, often not painful. Etiologically, hypertension and arteriosclerosis seem to be the main causes of non-traumatic aneurysms in STA. Differential diagnoses include subcutaneous hematoma, inflammatory diseases such as giant cell arteritis, sebaceous cyst, among others. Treatment of STA aneurysms is surgical. Considering that this is a rare entity, with a variety of differential diagnoses and a timely diagnosis being important, this case report is extremely relevant and aims to sensitize colleagues to this pathology.

Case description:

A 67-year-old woman was brought to a consultation due to a swelling in the right temporal region with a month of evolution, painful and accompanied by right temporal headache, with progressive worsening and no frank response to analgesic treatment. On objective examination, she presented a right temporal swelling, measuring around 1.5cm, non-pulsatile, hard, painful on palpation, without other inflammatory signs. No changes on neurological examination. Doppler ultrasonography revealed a thrombosed STA aneurysm. The patient underwent aneurysm excision seven days after the initial observation, without complications.

Comment:

Non-traumatic STA aneurysm is an extremely rare entity. In the situation of this patient, the atypia of pain on palpation of the swelling associated with localized headache, raised the suspicion in the family physician that it was not just ano-ther sebaceous cyst. For this reason, and despite being rare, the STA aneurysm should always be considered in any swelling that appears in the temporal region.

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