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A Rare Complication of the Thyroid Malignancies: Jugular Vein Invasion.

Dikici AS, Yıldırım O, Er ME, Kılıç F, Tutar O, Kantarcı F, Mihmanlı I - Pol J Radiol (2015)

Bottom Line: Therefore, total thyroidectomy with left neck dissection and segmental resection of the left internal jugular vein were performed, and the tumor thrombus was cleared successfully.Thrombosis of IJV is probably underdiagnosed.Early-stage diagnosis is important for long-term survival rates.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Cerrahpasa Medical Faculty, Istanbul, Turkey.

ABSTRACT

Background: Unilateral invasion of the internal jugular vein (IJV) after subtotal thyroidectomy caused by local recurrence of papillary thyroid carcinoma is extremely rare. We report a case of papillary thyroid carcinoma which invades IJV with hypervascular tumor thrombus.

Case report: We report a case of a 52-year-old woman with a history of previous thyroid operation who presented with a 2-month history of a painless, growing, hard, solitary mass on the left side of the neck. Clinical examination revealed also ipsilateral cervical lymphadenopathy. Radiological examination showed a necrotic and cystic mass arising from the operated area extending and invading the left jugular vein wall with hypervascular tumor thrombus. Cytological examination of the mass confirmed a papillary thyroid carcinoma (PTC) and enlarged metastatic lymph nodes. Therefore, total thyroidectomy with left neck dissection and segmental resection of the left internal jugular vein were performed, and the tumor thrombus was cleared successfully.

Conclusions: Invasion of IJV with hypervascular tumor thrombosis is an extremely rare condition in papillary thyroid carcinoma. Thrombosis of IJV is probably underdiagnosed. Early-stage diagnosis is important for long-term survival rates.

No MeSH data available.


Related in: MedlinePlus

Color Doppler ultrasound of neck; (A) the longitudinal image of the left internal jugular vein (IJV) shows the hyperechoic filling defect and vascularization of tumour thrombus (thick arrow). (B) the transvers image of the vascularization of thyroid mass (thin arrow) and the invasion region (arrow head).
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f2-poljradiol-80-360: Color Doppler ultrasound of neck; (A) the longitudinal image of the left internal jugular vein (IJV) shows the hyperechoic filling defect and vascularization of tumour thrombus (thick arrow). (B) the transvers image of the vascularization of thyroid mass (thin arrow) and the invasion region (arrow head).

Mentions: Ultrasonographic (US) examination revealed a 5.5×5.5 cm solitary mass with multiple areas of necrosis and cystic parts arising from the operated area, extending and invading the left jugular vein wall (Figure 1) displacing the left carotid artery posteriorly and laterally. It also showed multiple enlarged deep cervical lymph nodes. Color Doppler ultrasound revealed that the left internal jugular vein (IJV) was partially (approximately 80%) blocked with a tumor thrombus until the innominate vein (Figure 2), and the left common carotid artery was externally compressed by the mass. Moreover, the tumor thrombus was hypervascular in color Doppler ultrasound.


A Rare Complication of the Thyroid Malignancies: Jugular Vein Invasion.

Dikici AS, Yıldırım O, Er ME, Kılıç F, Tutar O, Kantarcı F, Mihmanlı I - Pol J Radiol (2015)

Color Doppler ultrasound of neck; (A) the longitudinal image of the left internal jugular vein (IJV) shows the hyperechoic filling defect and vascularization of tumour thrombus (thick arrow). (B) the transvers image of the vascularization of thyroid mass (thin arrow) and the invasion region (arrow head).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4509426&req=5

f2-poljradiol-80-360: Color Doppler ultrasound of neck; (A) the longitudinal image of the left internal jugular vein (IJV) shows the hyperechoic filling defect and vascularization of tumour thrombus (thick arrow). (B) the transvers image of the vascularization of thyroid mass (thin arrow) and the invasion region (arrow head).
Mentions: Ultrasonographic (US) examination revealed a 5.5×5.5 cm solitary mass with multiple areas of necrosis and cystic parts arising from the operated area, extending and invading the left jugular vein wall (Figure 1) displacing the left carotid artery posteriorly and laterally. It also showed multiple enlarged deep cervical lymph nodes. Color Doppler ultrasound revealed that the left internal jugular vein (IJV) was partially (approximately 80%) blocked with a tumor thrombus until the innominate vein (Figure 2), and the left common carotid artery was externally compressed by the mass. Moreover, the tumor thrombus was hypervascular in color Doppler ultrasound.

Bottom Line: Therefore, total thyroidectomy with left neck dissection and segmental resection of the left internal jugular vein were performed, and the tumor thrombus was cleared successfully.Thrombosis of IJV is probably underdiagnosed.Early-stage diagnosis is important for long-term survival rates.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Cerrahpasa Medical Faculty, Istanbul, Turkey.

ABSTRACT

Background: Unilateral invasion of the internal jugular vein (IJV) after subtotal thyroidectomy caused by local recurrence of papillary thyroid carcinoma is extremely rare. We report a case of papillary thyroid carcinoma which invades IJV with hypervascular tumor thrombus.

Case report: We report a case of a 52-year-old woman with a history of previous thyroid operation who presented with a 2-month history of a painless, growing, hard, solitary mass on the left side of the neck. Clinical examination revealed also ipsilateral cervical lymphadenopathy. Radiological examination showed a necrotic and cystic mass arising from the operated area extending and invading the left jugular vein wall with hypervascular tumor thrombus. Cytological examination of the mass confirmed a papillary thyroid carcinoma (PTC) and enlarged metastatic lymph nodes. Therefore, total thyroidectomy with left neck dissection and segmental resection of the left internal jugular vein were performed, and the tumor thrombus was cleared successfully.

Conclusions: Invasion of IJV with hypervascular tumor thrombosis is an extremely rare condition in papillary thyroid carcinoma. Thrombosis of IJV is probably underdiagnosed. Early-stage diagnosis is important for long-term survival rates.

No MeSH data available.


Related in: MedlinePlus