title: Incidental detection of internal jugular vein thrombosis secondary to undiagnosed benign substernal goiter.
abstract: Internal jugular vein thrombosis is a serious event with potentially fatal outcome, where the clinical symptoms may be vague or absent. This paper refers to a rare case where routine carotid Doppler ultrasound prior to coronary artery bypass grafting (CABG) and aortic valve replacement (AVR) in a 76-year-old man, incidentally revealed thrombosis of the right internal jugular vein. Thoracic CT demonstrated an underlying, large, benign substernal multinodular goiter, mainly involving the right lobe, causing compression and displacement of the great vessels. A successful, one-stage operation including ligation of the internal jugular vein to avoid pulmonary embolism and hemithyroidectomy, combined with the scheduled CABG and AVR, was performed. This case illustrates that benign substernal goiter may be associated with asymptomatic internal jugular vein thrombosis. Carotid Doppler ultrasound should involve evaluation of the internal jugular vein concerning thrombosis as its presence may reveal space-occupying lesions in the thorax.
authors.affiliation: Department of Heart Disease, Haukeland University Hospital, 5021 Bergen, Norway.
authors.forename: Mai Tone
authors.initials: MT
authors.lastname: Lønnebakken
authors.forename: Ole Martin
authors.initials: OM
authors.lastname: Pedersen
authors.forename: Knut Sverre
authors.initials: KS
authors.lastname: Andersen
authors.forename: Jan Erik
authors.initials: JE
authors.lastname: Varhaug
references.citation: Jpn Circ J. 1999 Dec;63(12):1004-6
references.pmid: 10614850
references.citation: Thyroid. 2010 Feb;20(2):235-6
references.pmid: 20151836
references.citation: J Clin Ultrasound. 2002 Jul-Aug;30(6):356-73
references.pmid: 12116098
references.citation: Clin Radiol. 1991 Jun;43(6):433-4
references.pmid: 2070592
references.citation: Postgrad Med J. 1998 Jun;74(872):327-9
references.pmid: 9799884
references.citation: Autoimmun Rev. 2007 Jun;6(6):379-86
references.pmid: 17537384
references.citation: Head Neck. 1994 Jan-Feb;16(1):72-4
references.pmid: 8125791
references.citation: J Clin Ultrasound. 2003 Feb;31(2):111-5
references.pmid: 12539254
references.citation: Radiology. 1987 Feb;162(2):505-8
references.pmid: 3541033
references.citation: Vascular. 2008 Mar-Apr;16(2):73-9
references.pmid: 18377835
references.citation: J Med Case Rep. 2007 Dec 20;1:184
references.pmid: 18096068
references.citation: Vasc Med. 2002 Aug;7(3):177-9
references.pmid: 12553740
references.citation: Thorac Cardiovasc Surg. 2007 Feb;55(1):56-8
references.pmid: 17285477
references.citation: World J Surg Oncol. 2008 Apr 03;6:36
references.pmid: 18387194