EXTENSION OF TUMOR THROMBUS TO INTERNAL JUGULAR VEIN IN FOLLICULAR 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.

Download Full-text

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.

Download Full-text