Great Cervical Vein Invasion of Thyroid Carcinoma

Abstract

Intraluminal tumor thrombus in great cervical veins as a result of thyroid carcinoma is extremely rare. Three patients (2 Hürthle cell, 1 papillary carcinoma) were surgically treated for thyroid carcinoma associated with tumor thrombus in the great cervical veins. Tumor thrombus in the internal jugular vein due to extension of thyroid carcinoma was found in these 3 patients. Segmental resection of the internal jugular vein was performed in all cases and a tumor thrombectomy from subclavian vein was accomplished in 1 patient. Histological examination verified intraluminal tumor thrombus resulting from invasion of thyroid carcinoma in all patients. The postoperative follow-up period ranged from 1 to 2 years. Of 2 patients undergoing completion thyroidectomy, 1 died of distant metastasis, the other underwent reoperation for local recurrence. The patient who had a definitive primary surgical procedure is free of recurrence. Appropriate initial surgical procedure in rare cases of thyroid carcinoma associated with intraluminal tumor thrombus in great cervical veins seems to improve the clinical outcome of the disease.

The surgical and adjuvant therapy options for thyroid malignancies infiltrating great vessels of the neck: A review of the literature

“…Tumour thrombectomy with or without resection of vein was carried out in 13 patients (37.14%). Reconstruction of the vein following resection of vein was carried out in 5 patients using either a saphenous vein graft, Gortex graft or PTFE graft (Onaran et al, 1998;Sugimoto et al, 2006;Panzironi et al, 2003;Leong et al, 2004;Taib and Hisham, 2007). In two patients the reconstruction was carried out with PTFE graft following resection of involved segment of an artery; carotid artery (Mishra et al, 2001) and brachiocephalic artery Lee et al (2010) in one patient each.…”

“…Massive invasion of tumour into the great veins of neck is extremely rare. Only 42 cases have been documented in the English literature (Hyer et al, 2008;Mishra et al, 2001;Patel et al, 1997;Lalak and Campbell, 1997;Onaran et al, 1998;Muta et al, 1978;Bussani and Silvestri, 1999;Koike et al, 2002;Wiseman et al, 2000;Thomas et al, 1991;Kim et al, 1966;Holt, 1934;Sugimoto et al, 2006;Sirota,1989;Niederle et al, 1990;Perez and Brown, 1984;Thompson et al, 1978;Gross et al, 2004;Takeichi et al, 1984;Panzironi et al, 2003;Alzaraa et al, 2008;Lee et al, 2010;Yamagami et al, 2008;Fotis et al, 2009;Leong et al, 2004;Motohashi et al, 2005;Taib and Hisham, 2007;Sengupta et al, 2001). Management of these patients is challenging as they typically present with advanced and rapidly progressive disease (Hyer et al, 2008;Mishra et al, 2001;Patelet al, 1997;Lee et al, 2010;Sengupta et al, 2001) (Table 1).…”

Successful surgical treatment of advanced follicular thyroid carcinoma with tumor thrombus infiltrating the superior vena cava: report of a case

“…Thus, aggressive surgery is thought to be justified for DTC with SVC involvement [11]. Several successful operations for poorly DTC [13,15,18,20] or Hurthle cell carcinoma [21] have been reported, even when the surgical indications might have been limited because of its invasive nature. Rapid progression of the disease with systemic dissemination after surgery for ATC [7,8], and for PTC possibly transformed to ATC [14], have been reported.…”

Poorly Differentiated Thyroid Carcinoma with Gross Internal Jugular Vein Invasion and Multiple Lung Metastases

“…2,9) Invasion of the internal jugular or great cervical veins by thyroid carcinoma is rare and usually indicates the aggressive nature of the disease and a high probability of mortality. 10,11)…”