Abstract
RATIONALE: Subclavian vein aneurysms are an exceedingly rare vascular anomaly, often diagnosed incidentally due to their nonspecific or absent clinical manifestations. Due to the limited number of reported cases and the lack of standardized diagnostic and management protocols, clinical decision-making remains challenging. This report presents a rare incidental case managed conservatively and is accompanied by a comprehensive literature review to consolidate existing knowledge on clinical presentation, associated risk factors, imaging modalities, and management approaches. By synthesizing available data, this study aims to support clinicians in recognizing this unusual entity and guide evidence-informed, individualized management strategies in the absence of formal guidelines. PATIENT CONCERN: A 37-year-old previously healthy male presented with persistent posterior neck pain for 1 month. DIAGNOSIS: Imaging studies, including magnetic resonance angiography and computed tomography angiography, identified a fusiform aneurysmal dilation of the right subclavian vein measuring 2.2 × 2.0 × 1.7 cm. INTERVENTION: A multidisciplinary team decided on conservative management, focusing on lifestyle modifications, analgesics, and closed follow-up, as the aneurysm was stable and asymptomatic regarding vascular complications. OUTCOME: During follow-up at 3, 6, and 12 months, the patient experienced gradual symptom improvement. Imaging confirmed the aneurysm remained stable without complications. LESSONS: This case highlights the importance of considering subclavian vein aneurysms in the differential diagnosis of neck pain and supraclavicular masses. It further emphasizes the important role of imaging in their identification and monitoring. By reviewing previously reported cases, this study contributes valuable insights into their clinical presentation, diagnostic modalities, and management strategies.