Superior vena cava syndrome from an invasive thymoma with transcaval invasion to the right atrium.
Invasive thymoma with transcaval extension to the right atrium is a rare cause of superior vena cava syndrome. We present a case on a 74-year-old female presenting with dyspnea on exertion, and facial and upper extremity swelling. Physical examination revealed mild facial swelling, non-pitting edema involving the upper extremities and distention of superficial veins of the anterior chest wall and jugular veins. An echocardiogram showed moderate right atrial dilation with a mobile mass in the atrial cavity prolapsing through the tricuspid valve. Cardiac magnetic resonance imaging revealed a 9.9 × 4.3 cm heterogeneous mass in the anterior mediastinum compressing the superior vena cava and endovenously extending into the right atrium. Tissue biopsy of the mediastinal mass revealed a type B1 thymoma, further staged as a Masaoka IVa invasive thymoma that underwent successfulen blocresection followed by removal of intracaval and right atrial mass.
Department of Internal Medicine, New York Methodist Hospital affiliate of Weill Medical College of Cornell University, Brooklyn, NY, USA.
Ashwad
A
Afzal
Department of Internal Medicine, New York Methodist Hospital affiliate of Weill Medical College of Cornell University, Brooklyn, NY, USA.
Ivan
I
Wong
Department of Cardiology, New York Methodist Hospital affiliate of Weill Medical College of Cornell University, Brooklyn, NY, USA.
Aleksandr
A
Korniyenko
Department of Cardiology, New York Methodist Hospital affiliate of Weill Medical College of Cornell University, Brooklyn, NY, USA.
Alex
A
Ivanov
Department of Cardiothoracic Surgery, New York Methodist Hospital affiliate of Weill Medical College of Cornell University, Brooklyn, NY, USA.
Berhane
B
Worku
Department of Cardiothoracic Surgery, New York Methodist Hospital affiliate of Weill Medical College of Cornell University, Brooklyn, NY, USA iog9001@nyp.org.
Iosif
I
Gulkarov