Abstract
The patient was a 66-year-old man with medical histories of hypertension and chronic renal failure. Since May 2009, his condition needed hemodialysis. Hemodialysis was introduced by a double-lumen catheterization for dialysis through the right internal jugular vein, and simultaneously internal shunt was created in the right forearm. Echography of the thyroid and carotid artery conducted in November 2010 disclosed a 26×11×9 mm tumor in the right internal jugular vein. The tumor was not adjacent to the venous wall and appeared to be anchored to the venous wall at the head side by a cord. In order to prevent pulmonary thromboembolism, the tumor in the right internal jugular vein was removed under general anesthesia. The tumor was clarified to be a thrombus in the shape of a rugby ball that was anchored to the venous wall by cords at its head and tail side, respectively. The cords looked like venous valve.
Surgical treatment for deep venous thrombosis affecting veins of the upper limb, cervical vein and superior vena cava is employed only when internal therapy is unsuccessful. However, we performed thrombectomy in this case, because the thrombus was tumorous and had a specific morphology so that pulmonary thromboembolism was expected to occur in a high incidence if it could migrate.
