We report varicosities affecting the right deep femoral vein and the right femoral vein consequent to a unique unilateral variation in the course of the small saphenous vein. The right small saphenous vein, instead of draining into the popliteal vein at the popliteal fossa, expanded considerably in girth and thickness and continued as the deep femoral vein. The deep femoral vein then pierced the adductor magnus muscle, appeared in the anterior compartment, and joined the femoral vein. Four centimeters distal to this junction, a two-centimeter long varicosity in the deep femoral vein was noted. There was also a one-centimeter long varicosity on the femoral vein at its point of attachment to the deep femoral vein. The abnormal course of the small saphenous vein has several clinical implications, including pathogenesis and treatment of varicose veins, planning of coronary artery bypass grafting, and pathogenesis of venous thrombosis and pulmonary embolism.
