Bordigoni L, Blin D, Magnan P E, Giudicelli R, Fuentes P
Service de Chirurgie Thoracique et des Maladies de l'Oesophage, Hôpital Sainte-Marguerite, Marseille.
Ann Radiol (Paris). 1992;35(7-8):559-63.
Microscopic angio-invasion by carcinoma of the thyroid is known. Extension into the great veins is much more uncommon. Most of the cases which have been previously described were discovered on post-mortem examination. We report the case of a 55 year-old woman who was found to have an asymptomatic small cervical goiter 6 years ago; during the last 12 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 leading to thrombosis and ectasia of the SVC. Surgery was performed with resection of the whole thyroid, the SVC and the innominate veins. A double prosthetic venous by pass was then inserted between the innominate veins and right atrium. Five years after resection, the patient has no recurrence or metastasis and no clinical symptom of SVC syndrome. To our knowledge, this is only the third reported case successfully treated by surgery.
甲状腺癌的微小血管侵犯是已知的。肿瘤延伸至大静脉则更为罕见。之前描述的大多数病例是在尸检时发现的。我们报告一例55岁女性病例，该患者6年前被发现有一个无症状的小颈部甲状腺肿；在过去12个月里，她出现了上腔静脉（SVC）综合征，放射学检查（血管造影、CT扫描）和手术探查显示为甲状腺癌，肿瘤腔内延伸导致SVC血栓形成和扩张。手术切除了整个甲状腺、SVC和无名静脉。然后在无名静脉和右心房之间插入了一个双人工血管旁路。切除术后五年，患者无复发或转移，也没有SVC综合征的临床症状。据我们所知，这是第三例报告的通过手术成功治疗的病例。
