ECTATIC TUMOR THROMBOSIS OF THE SUPERIOR VENA-CAVA REVEALING A THYROID-CANCER

Microscopic angio-invasion by carcinoma of the thyroid is known. Exten sion into the great veins is much more uncommon. Most of the cases whi ch have been previously described were discovered on post-mortem exami nation. We report the case of a 55 year-old woman who was found to hav e an asymptomatic small cervical goiter 6 years ago; during the last 1 2 months she developed superior vena cave (SVC) syndrome radiological investigation (angiography, CT scan) and surgical exploration showed a carcinoma of the thyroid with intraluminal extension of the tumor lea ding to thrombosis and ectasia of the SVC. Surgery was performed with resection of the whole thyroid, the SVC and the innominate veins. A do uble prosthetic venous by pass was then inserted between the innominat e veins and right atrium. Five years after resection, the patient has no recurrence or metastasis and no clinical symptom of SVC syndrome. T o our knowledge, this is only the third reported case successfully tre ated by surgery.