Unusual Presentation of Gonadal Vein Aneurysm - Thrombosis and Hydronephrosis: A Rare Case Report

Gonadal vein aneurysm is a very rare anomaly and the aetiology is often unknown. Many factors have been said as contributory such as multiple pregnancies, multiple pelvic surgeries, pelvic tumours or pelvic congestion, but none of them have been strongly or closely associated with the lesion. Here, we present a case of left gonadal vein aneurysm in a female with its management. A 72- year-old, diabetic and hypertensive female presented with complaints of left loin pain. She is multiparous with four normal vaginal deliveries. On evaluation, she was diagnosed to have 4 cm left gonadal vein aneurysmal mass with internal thrombus causing hydronephrosis due to mass compression and perilesional adhesions. She underwent left gonadal vein aneurysm excision. Many treatment options are available such as endovascular– embolization/sclerotherapy. In the presence of thrombus and dense adhesions, as noted in our case, it is best to do open surgery for safety of the patient and obtain a good outcome.