Thyroid Carcinoma with Internal Jugular Vein Thrombus : Report of a Case

Abstract

A thyroid carcinoma with a tumor thrombus in the great cervical veins is an extremely rare condition. We report herein a case of a 74-year-old woman with papillary thyroid carcinoma together with an internal jugular vein thrombus. The patient with a right anterior neck tumor, diagnosed as papillary carcinoma, was referred to our hospital. Computed tomography identified a low-density mass with heterogeneous enhancement at the right thyroid lobe and a right internal jugular vein stenosis. During surgery, a tumor thrombus was detected in the right jugular vein. Both a total thyroidectomy with a modified neck dissection and a segmental resection of the right jugular vein with the tumor thrombus were performed. The pathological examination verified poorly differentiated papillary carcinoma with muscle invasion and lymph node involvement. The patient received postoperative treatment of 100 mCi of ¹³¹I, followed by thyroid stimulating hormone suppression therapy with thyroxine. The patient is free from recurrence 6 months after the operation. Computed tomography was the most useful tool in the preoperative diagnosis of thyroid carcinoma with a tumor thrombus. More precise preoperative diagnosis is an important factor in the clinical outcome. (Kitakanto Med J 2003 ; 53 : 315318)