H. Chahed1; M Cherif1; A Mediouni1 ; R Jebnoun1; R Zainine1 ; R. Bechraoui1; J Marrakchi 1; N Beltaief1; F. Ghdira2; G Besbes1; R Denguir2.
1Department of ENT surgery, Rabta Hospital, Tunis, Tunisia
2Department of cardiovascular surgery; Rabta Hospital, Tunis, Tunisia

Objective: To report a rare misleading diagnosis of an acute cervical swelling.
Observation: We present the case of a 45 year old man who presented to our emergency department with a neck swelling which had been evolving since a week, with no improvement on antibiotics. A CT-scan with contrast revealed a thrombosed internal carotid artery aneurysm. The patient underwent a resection of the aneurysm and an end to end reconstruction with a venous graft.
Conclusion: Extracranial internal carotid aneurysms are rare but ENT surgeon must keep in mind such a diagnosis face to an acute laterocervical swelling. Cervical angio-CT scan confirms the diagnosis and guides the therapeutic management.
Key words: Aneurysm, Internal carotid, Neck mass, Angio CT scan, surgery

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