Thyroid carcinoma with extensive tumor thrombus in the superior vena cava: A case report.
BACKGROUND
Venous tumor thrombus of thyroid cancer that extend to the great vein is rare, and management criteria for venous thrombus have not been established yet. We report a surgical case of thyroid carcinoma with extensive tumor thrombus in the superior vena cava (SVC) and consider the appropriate treatment strategy for venous thrombus.


METHODS
A 75-year-old woman consulted our hospital because of thyroid carcinoma with an extensive tumor thrombus. Computed tomography (CT) revealed a solitary thyroid mass with extensive continuous tumor thrombus in the left internal jugular vein, innominate vein, and SVC. We planned complete tumor resection. During operation, the tumor thrombus in the SVC disappeared, suggesting that pulmonary embolism occurred. Therefore, she underwent total thyroidectomy with extensive phlebectomy (the innominate and internal jugular veins). Although she had some morbidities during her postoperative course, she was followed up for 6 months without progression of thyroid cancer.


CONCLUSIONS
Intravascular tumor extension of thyroid carcinoma is rare, but is a life-threatening complication. For patients with thyroid tumor with venous tumor thrombus, segmental resection and thrombectomy should be considered if radical operation is possible. Therefore, preoperative correct imaging evaluation and operative planning are necessary to perform safe and effective operations. We suggest a management criteria for patients with thyroid carcinoma with venous tumor thrombus.
Faculity of Medicine, University of Miyazaki, Department of Surgery, Japan. Electronic address: fkawano@med.miyazaki-u.ac.jp.
Fumiaki
F
Kawano
Faculity of Medicine, University of Miyazaki, Department of Surgery, Japan.
Masaki
M
Tomita
Faculity of Medicine, University of Miyazaki, Department of Surgery, Japan.
Hiroyuki
H
Tanaka
Faculity of Medicine, University of Miyazaki, Department of Surgery, Japan.
Hiroyuki
H
Nagahama
Faculity of Medicine, University of Miyazaki, Department of Surgery, Japan.
Kousei
K
Tashiro
Faculity of Medicine, University of Miyazaki, Department of Surgery, Japan.
Hironobu
H
Nakao
Faculity of Medicine, University of Miyazaki, Department of Surgery, Japan.
Hiroaki
H
Kataoka
Faculity of Medicine, University of Miyazaki, Department of Surgery, Japan.
Kunihide
K
Nakamura
Phlebectomy; Pulmonary embolism and case report; Thrombectomy; Thyroid carcinoma; Venous tumor thrombus