Tumor thromboembolization into the internal jugular vein through its draining vein: A preoperative radiologic feature of high-risk thyroid cancer

Objective: We aimed to present a case with a previous thyroid surgery, who developed an internal jugular vein thrombus due to papillary thyroid cancer (PTC) in the remnant tissue. Case: A 54-year-old female patient, with a previous subtotal thyroidectomy, presented with a mass on the left side of her neck. Thyroid ultrasound disclosed a heterogeneous nodule of 67x48x32 mm in the left thyroid lobe. An isoechoic tumor thrombus was observed extending intraluminally from the middle thyroid vein to the internal jugular vein. No lymph node or solid organ invasion were detected in the neck. Fine needle aspiration biopsy revealed cytological findings consistent with PTC. Total thyroidectomy, left sided central neck dissection and partial left jugular vein resection was performed. The pathologic examination revealed mid-differentiated unifocal encapsulated follicular variant of PTC. The whole-body scan performed after the postoperative treatment of 150 mCi of radioactive iodine, revealed multiple lung metastases. Conclusion: The presence of a tumor thrombus in the thyroid vein or internal jugular vein is strongly suspicious for malignancy even in the absence of malignant findings on cytology. It is an important finding that is highly suspicious for distant metastasis in the cytologically diagnosed patients.

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US-guided placement of temporary internal jugular vein catheters: immediate technical success and complications in normal and high-risk patients

European Journal of Radiology ◽

10.1016/j.ejrad.2004.10.004 ◽

2005 ◽

Vol 55 (1) ◽

pp. 125-129 ◽

Cited By ~ 49

Author(s):

Levent Oguzkurt ◽

Fahri Tercan ◽

Gulcan Kara ◽

Dilek Torun ◽

Osman Kizilkilic ◽

...

Keyword(s):

High Risk ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Technical Success ◽

High Risk Patients ◽

Risk Patients

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33. Thyroid Cancer Invasion into the Internal Jugular Vein

Diagnostic Dilemmas: Images in Endocrinology ◽

10.1210/dde1.9781936704583.ch33 ◽

2011 ◽

pp. 186-187

Author(s):

Nadarajah Mugunthan

Keyword(s):

Thyroid Cancer ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Cancer Invasion

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Procedural sedation with dexmedetomidine for ultrasound guided central venous cannulation in agitated, high risk critically ill patients. A series of three cases

Bangladesh Critical Care Journal ◽

10.3329/bccj.v5i1.32546 ◽

2017 ◽

Vol 5 (1) ◽

pp. 68-69

Author(s):

Gentle S Shrestha ◽

Bashu Dev Parajuli ◽

Amit Sharma Bhattarai

Keyword(s):

High Risk ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Procedural Sedation ◽

Venous Cannulation ◽

Central Venous Cannulation ◽

Ultrasound Guided ◽

Central Venous ◽

Effective Agent ◽

Risk Patients

Central venous cannulation is a commonly performed procedure in ICU. Even in the experienced hands, it is not free of complications. Acute mechanical adverse events are more likely in agitated and uncooperative patients. Ultrasound guided cannunation of internal jugular vein is associated with higher success rate and fewer mechanical complications when compared with traditional techniques. Dexmedetomidine has been used as a safe and effective agent for procedural sedation in a wide variety of patients. Here we successfully used dexmedetomidine for ultrasound guided central venous cannulation of internal jugular vein in uncooperative high risk patients, even at the extremes of age.Bangladesh Crit Care J March 2017; 5(1): 68-69

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EXTENSION OF TUMOR THROMBUS TO INTERNAL JUGULAR VEIN IN FOLLICULAR THYROID CANCER

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) ◽

10.3919/jjsa.65.34 ◽

2004 ◽

Vol 65 (1) ◽

pp. 34-37 ◽

Cited By ~ 2

Author(s):

Takafumi SEKINO ◽

Takuya YAMADA ◽

Hisashi IWATA ◽

Hiroshi MATSUO ◽

Koyo SHIRAHASHI ◽

...

Keyword(s):

Thyroid Cancer ◽

Internal Jugular Vein ◽

Tumor Thrombus ◽

Jugular Vein ◽

Follicular Thyroid Cancer

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Uncomplicated Central Vein Catheterization of High Risk Patients with Real Time Ultrasound Guidance

The International Journal of Artificial Organs ◽

10.1177/039139889501800302 ◽

1995 ◽

Vol 18 (3) ◽

pp. 117-121 ◽

Cited By ~ 23

Author(s):

M. Gallieni ◽

M. Cozzolino

Keyword(s):

High Risk ◽

Internal Jugular Vein ◽

Ultrasound Guidance ◽

Jugular Vein ◽

Complication Rates ◽

Internal Jugular Vein Cannulation ◽

High Risk Patients ◽

Vein Cannulation ◽

Risk Patients ◽

External Landmark

Internal jugular vein cannulation has become a routine and clinically important aspect of medical care of critically ill patients. The landmark guided technique usually affords rapid and easy vascular access, but is not always successful and may be complicated by arterial puncture, hematoma, or pneumothorax. Some categories of patients, in particular patients with no external landmarks and patients with coagulopathies, appear to be at an increased risk of complications. We report the experience of internal jugular vein cannulation by a single operator with the external landmark technique in 10 patients and with ultrasound guidance in 31 patients, including 12 high risk patients. These patients had severe coagulopathies due to hepatic failure, HELLP syndrome, excess of anticoagulation treatment, or they had no external anatomic landmarks because of anasarca or obesity, were unable to maintain the horizontal position, or were external landmark catheterization failures. With the availability of the ultrasound device, success and complication rates improved markedly, suggesting that the ultrasound technique is easy to learn and rapidly produces an improvement over the external landmark method. In particular the 13 cannulations performed in 12 high risk patients were all successful at the first attempt, with no complications. In the overall population successful cannulations improved from 80% to 100%, first attempt success from 20% to 87% and carotid punctures decreased from 33% to 3.2%. Our results confirm that ultrasound guided cannulation of the internal jugular vein allows safer operation in high risk patients or when access problems are anticipated.

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Septic thrombosis of internal jugular vein: a rare cause of uncontrollable hiccups

Journal of Surgical Case Reports ◽

10.1093/jscr/rjz266 ◽

2019 ◽

Vol 2019 (9) ◽

Author(s):

Ana Sánchez-Gollarte ◽

Jose María Mugüerza-Huguet ◽

Manuel Mariano Díez-Alonso ◽

Enrique Ovejero-Merino ◽

Fernando Mendoza-Moreno ◽

...

Keyword(s):

High Risk ◽

Conservative Treatment ◽

Internal Jugular Vein ◽

Phrenic Nerve ◽

Surgical Intervention ◽

Jugular Vein ◽

Central Venous Catheters ◽

Central Venous ◽

Risk Patients ◽

Septic Thrombosis

Abstract Septic thrombosis of the internal jugular vein is a possible complication related to central venous catheters. The enlargement of the diameter of the jugular vein can stimulate phrenic nerve causing hiccups and, septic thrombus can metastasize to different organs threating patient’s life. Diagnosis of septic thrombosis of internal jugular vein should be confirmed with a cervicothoracic CT-scan. Its management consists of catheter’s removal, antibiotic treatment and anticoagulation in high-risk patients. Surgical intervention might be considered if conservative treatment fails.

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Case Report: Superior Vena Cava Resection and Reconstruction for Invasive Thyroid Cancer: Report of Three Cases and Literature Review

Frontiers in Surgery ◽

10.3389/fsurg.2021.644605 ◽

2021 ◽

Vol 8 ◽

Author(s):

Wenjie Chen ◽

Jianyong Lei ◽

Yichao Wang ◽

Xiaojun Tang ◽

Bin Liu ◽

...

Keyword(s):

Thyroid Cancer ◽

Internal Jugular Vein ◽

Superior Vena Cava ◽

Tumor Thrombus ◽

Jugular Vein ◽

Superior Vena ◽

Femoral Vein ◽

Vena Cava ◽

Comprehensive Treatment ◽

The Right

Background: Thyroid cancer with massive invasion into the cervical and mediastinal great veins is extremely rare, and the surgical treatment is controversial, thus posing a great challenge for head and neck surgeons. Here, we report our successful experiences in reconstructing the superior vena cava (SVC) system to treat thyroid cancer with an extensive tumor thrombus growing intraluminally into the SVC.Case Presentation: From September 2019 to September 2020, three patients with superior vena cava syndrome(SVCS) caused by tumor thrombus invasion from thyroid cancer were continuously included in this series. After preoperative evaluation, radical resection and reconstruction of the SVC system with expanded polytetrafluoroethylene (EPTFE) grafts were performed. In addition, bypass support from the right internal jugular vein to the right femoral vein was routinely prepared intraoperatively to prevent a rise in central venous pressure (CVP). Postoperatively, SVC-related syndrome improved immediately after the operation. Imaging examination showed good function of the reconstructed venous system. The patients recovered well with no surgical complications and remain under continuous follow-up.Conclusions: Tumor growth into the SVC does not seem to be an absolute contraindication for surgery for thyroid carcinoma. Comprehensive treatment, including reconstruction of the SVC, is effective for relieving symptoms and preventing disease progression and is thus worth advocating. In addition, bypass support from the internal jugular vein to the femoral vein is easy to implement and can improve the safety of the operation.

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