title: Successful surgical treatment of advanced follicular thyroid carcinoma with tumor thrombus infiltrating the superior vena cava: report of a case.
abstract: We report a case of advanced follicular thyroid carcinoma with massive involvement of the great veins of the cervix and mediastinum, and extensive tumor thrombus growing intraluminally into the superior vena cava. The patient, a 70-year-old Japanese woman, was treated successfully by a cooperative surgical team of endocrine and cardiovascular surgeons. Total thyroidectomy with thrombectomy was performed via a minimum phlebotomy in the right brachiocephalic vein, sacrificing only the right internal jugular vein, achieving complete primary tumor resection. She recovered quickly without any complications, and received (131)I radioisotope ablation for her multiple lung metastases. At the time of writing, more than 12 months after surgery, she was well. These treatments thus achieved progression-free survival without impairing her quality of life. Following the case report, we discuss the surgical indications for locally advanced thyroid carcinoma involving the great veins of the mediastinum by reviewing previous reports.
authors.affiliation: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan. nonoda@med.osaka-cu.ac.jp
authors.forename: Naoyoshi
authors.initials: N
authors.lastname: Onoda
authors.forename: Masanori
authors.initials: M
authors.lastname: Nakamura
authors.forename: Mitsuharu
authors.initials: M
authors.lastname: Hosono
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Sasaki
authors.forename: Hidemi
authors.initials: H
authors.lastname: Kawajiri
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takashima
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Kosei
authors.initials: K
authors.lastname: Hirakawa
mesh_terms: D018263:Adenocarcinoma, Follicular; D000368:Aged; D044963:Biopsy, Fine-Needle; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009361:Neoplasm Invasiveness; D017131:Thrombectomy / Q000379:methods*; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D014683:Vena Cava, Superior; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*
references.citation: Arch Surg. 1984 Mar;119(3):323-6
references.pmid: 6696626
references.citation: Surgery. 1990 Dec;108(6):951-6; discussion 956-7
references.pmid: 2247840
references.citation: Surg Today. 2002;32(1):59-62
references.pmid: 11871819
references.citation: Acta Med Okayama. 2006 Apr;60(2):135-40
references.pmid: 16680191
references.citation: World J Surg Oncol. 2009 Oct 13;7:75
references.pmid: 19825162
references.citation: J Laryngol Otol. 2005 Aug;119(8):585-91
references.pmid: 16102210
references.citation: Asian J Surg. 2007 Jul;30(3):216-9
references.pmid: 17638642
references.citation: Otolaryngol Head Neck Surg. 1997 Dec;117(6):S117-20
references.pmid: 9419122
references.citation: Thyroid. 1998 Jan;8(1):59-61
references.pmid: 9492155
references.citation: J Clin Oncol. 2010 Apr 1;28(10):e151-4
references.pmid: 20048178
references.citation: Eur J Surg Oncol. 2000 Dec;26(8):816-7
references.pmid: 11087652
references.citation: Surg Today. 2010 Mar;40(3):254-6
references.pmid: 20180080
references.citation: World J Surg Oncol. 2009 Apr 17;7:40
references.pmid: 19374744
references.citation: Clin Nucl Med. 2008 Jun;33(6):426-8
references.pmid: 18496455
references.citation: Endocr Pract. 2000 Nov-Dec;6(6):469-76
references.pmid: 11155222
references.citation: Gen Thorac Cardiovasc Surg. 2008 Nov;56(11):555-8
references.pmid: 19002756
references.citation: Surgery. 1978 Apr;83(4):451-7
references.pmid: 635781
references.citation: Can Med Assoc J. 1966 Jan 29;94(5):238-43
references.pmid: 5902240
references.citation: J Thorac Cardiovasc Surg. 2002 Sep;124(3):635-6
references.pmid: 12202885
references.citation: Jpn J Thorac Cardiovasc Surg. 2005 Jan;53(1):55-7
references.pmid: 15724506
references.citation: Surg Clin North Am. 2009 Oct;89(5):1171-91
references.pmid: 19836491
references.citation: Otolaryngol Head Neck Surg. 2005 Mar;132(3):490-4
references.pmid: 15746868
references.citation: World J Surg Oncol. 2008 Apr 03;6:36
references.pmid: 18387194