Superior vena cava syndrome caused by a benign intrathoracic goiter

Abstract

Intrathoracic goiters are defined as the extension of the thyroid gland into the mediastinum. Superior Vena Cava (SVC) syndrome due to the compression of major vessels can be seen in these patients. Most cases of SVC syndrome occur as a complication of malignancy. A 75-year-old female, non-smoker, was admitted with complaints of the midline neck swell- ing for the past 45 years, mild puffiness of face, breathlessness on lying down and dry cough for last 5 years. On clinical examination, there was a massive grade IV thyromegaly. Neck computed tomography revealed a heterogeneous, hyper- trophic, nodular thyroid gland with multiple calcification and mediastinal extension with narrowed trachea. Intraoperatively, there was a huge retrosternal thyroid gland compression of the right brachiocephalic vein, the brachiocephalic trunk from behind the vessel and the right carotid artery along with the right internal jugular vein. Pathological examination showed a nodular colloid goitre without signs of malignancy. When SVC syndrome is secondary to benign thyroid disease, total thyroidectomy should be performed. [Arch Clin Exp Surg 2016; 5(4.000): 242-245]

Keywords

• Vena cava superior syndrome
• goiter
• thyroidectomy