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Superior vena cava syndrome from an invasive thymoma with transcaval invasion to the right atrium.

Afzal A, Wong I, Korniyenko A, Ivanov A, Worku B, Gulkarov I - J Surg Case Rep (2016)

Bottom Line: 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.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Internal Medicine, New York Methodist Hospital affiliate of Weill Medical College of Cornell University, Brooklyn, NY, USA.

No MeSH data available.


Related in: MedlinePlus

CMR axial four-chamber view: mass in the right atrial cavity protruding through the tricuspid valve into the right ventricle.
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RJW044F3: CMR axial four-chamber view: mass in the right atrial cavity protruding through the tricuspid valve into the right ventricle.

Mentions: A 74-year-old female presented with facial and upper extremity swelling over the last month. The swelling was worse in the morning and improved throughout the day. The patent also reported dyspnea on exertion. A review of systems was otherwise negative. Social history was notable for 40-pack-year smoking history, but she quit smoking 12 years ago. Her vital sign were stable. Physical examination revealed mild facial swelling, non-pitting edema of the upper extremities and distention of superficial veins of the anterior chest wall and jugular veins. There were no significant laboratory abnormalities. An echocardiogram showed moderate right atrial dilation with a mobile mass in the atrial cavity prolapsing through the tricuspid valve, bowing of atrial septum from right to left consistent with increased right atrial pressure, moderate tricuspid regurgitation and normal left ventricular ejection fraction with no regional wall motion abnormalities. Cardiovascular magnetic resonance imaging revealed a 9.9 × 4.3 cm heterogeneous mass admixed with thrombus in the anterior mediastinum compressing the SVC and endovenously extending into the right atrium (Figs 1–3). Anticoagulation with heparin drip was initiated. A computed tomography (CT)-guided biopsy revealed a tan-colored mass with CD5 lymphocyte predominance, inconspicuous epithelial cells positive for P63 expression and cytokeratin AE1/AE3 that was morphologically consistent with thymoma type B1.Figure 1:


Superior vena cava syndrome from an invasive thymoma with transcaval invasion to the right atrium.

Afzal A, Wong I, Korniyenko A, Ivanov A, Worku B, Gulkarov I - J Surg Case Rep (2016)

CMR axial four-chamber view: mass in the right atrial cavity protruding through the tricuspid valve into the right ventricle.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4837328&req=5

RJW044F3: CMR axial four-chamber view: mass in the right atrial cavity protruding through the tricuspid valve into the right ventricle.
Mentions: A 74-year-old female presented with facial and upper extremity swelling over the last month. The swelling was worse in the morning and improved throughout the day. The patent also reported dyspnea on exertion. A review of systems was otherwise negative. Social history was notable for 40-pack-year smoking history, but she quit smoking 12 years ago. Her vital sign were stable. Physical examination revealed mild facial swelling, non-pitting edema of the upper extremities and distention of superficial veins of the anterior chest wall and jugular veins. There were no significant laboratory abnormalities. An echocardiogram showed moderate right atrial dilation with a mobile mass in the atrial cavity prolapsing through the tricuspid valve, bowing of atrial septum from right to left consistent with increased right atrial pressure, moderate tricuspid regurgitation and normal left ventricular ejection fraction with no regional wall motion abnormalities. Cardiovascular magnetic resonance imaging revealed a 9.9 × 4.3 cm heterogeneous mass admixed with thrombus in the anterior mediastinum compressing the SVC and endovenously extending into the right atrium (Figs 1–3). Anticoagulation with heparin drip was initiated. A computed tomography (CT)-guided biopsy revealed a tan-colored mass with CD5 lymphocyte predominance, inconspicuous epithelial cells positive for P63 expression and cytokeratin AE1/AE3 that was morphologically consistent with thymoma type B1.Figure 1:

Bottom Line: 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.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Internal Medicine, New York Methodist Hospital affiliate of Weill Medical College of Cornell University, Brooklyn, NY, USA.

No MeSH data available.


Related in: MedlinePlus