Pulsatile buttock mass: report of two cases and a review of the literature.

The presence of any pulsatile mass suggests an underlying aneurysm. When such masses occur in the buttock, the differential diagnosis includes aneurysms arising from branches of gluteal vessels or aneurysms developing in a persistent sciatic artery (PSA). The investigation and management of two patients with pulsatile masses are described. Review of the embryologic aspects of these masses and the important literature on the subject led to the conclusions that when a pulsatile buttock mass is encountered, an anomalous PSA should be suspected. A gluteal artery aneurysm can be treated by ligation or occlusion, but for a sciatic artery aneurysm surgical ablation is necessary and distal perfusion must be achieved postoperatively.