Massive carotid artery aneurysm presenting as an oropharyngeal swelling in a young woman.

A 28-year-old woman presented to the emergency department with a 5-day history of a sore throat and a pharyngeal swelling that increased in size. The patient was previously investigated for Marfan's syndrome after episodes of bilateral spontaneous pneumothoraces but did not meet the criteria for diagnosis. Examination revealed a large pulsatile lesion in the oropharynx. CT angiography revealed an internal carotid artery aneurysm. The patient underwent a successful urgent open repair of the aneurysm with a primary arterio-arterial anastomosis without a patch. Histopathology of the aneurysmal sac revealed cystic medial degeneration. 2015 BMJ Publishing Group Ltd.