Dual culprit for a swollen leg: Femoral vein compression caused by lymphadenopathy and a synovial cyst

A young man had presented to the clinic with unilateral leg swelling with concerns for deep vein thrombosis. Imaging studies revealed external compression of the left common femoral vein due to enlarged lymph nodes and a cystic structure in the left groin. He underwent surgical exploration with resection of multiple compressive lymph nodes but continued to remain symptomatic. He underwent reexploration of his groin to remove a cystic structure posterior to the vein, with complete resolution of his symptoms. The enlarged lymph nodes were reactive, and the cyst was consistent with a synovial cyst on pathologic examination. Complete resection is warranted when exploring the causes of external venous compression.