Resection of Papillary Thyroid Carcinoma Occupying the Superior Vena Cava and Right Atrium under Cardiopulmonary Bypass in a Patient with Severe Superior Vena Cava Syndrome: A Case Report
Vol 9 | Issue 2 | May-August 2023 | Page: 01-04 | Kazutomo Saito, Masanori Yamauchi
Author: Kazutomo Saito, Masanori Yamauchi 
 Anaesthesiology and Perioperative Medicine, Tohoku University Graduate School of Medicine, 2-1 Seiryomachi, Aoba-ku, Sendai, Miyagi, Japan.
Address of Correspondence
Dr. Kazutomo Saito
Anaesthesiology and Perioperative Medicine, Tohoku University Graduate School of Medicine, 2-1 Seiryomachi, Aoba-ku, Sendai, Miyagi, Japan.
Introduction: Papillary thyroid carcinoma with an extensive tumor thrombus growing into the superior vena cava and right atrium is rare. Only a few case reports have described the surgical resection of thyroid carcinoma and extensive tumor thrombus under cardiopulmonary bypass.
Case presentation: We encountered a 79-year-old woman with papillary thyroid carcinoma who developed severe superior vena cava syndrome caused by an extensive tumor thrombus. Radical resection of the thyroid carcinoma and tumor thrombus was performed under cardiopulmonary bypass. Both the innominate vein and inferior vena cava pressures were continuously monitored during the surgical procedure. The innominate vein pressure was measured using a peripherally inserted central venous catheter (PICC) via the left basilic vein. The initial central venous pressures at the innominate vein and inferior vena cava were 22 mmHg and 8 mmHg, respectively. After tumor resection, the pressure gradient between the innominate vein and inferior vena cava was markedly decreased. At the end of the surgery, the pressure gradient had almost disappeared.
Conclusion: Central venous pressure monitoring at the innominate vein through PICC was useful in detecting the failure of venous drainage from the innominate vein or in diagnosing the perioperative recurrence of superior vena cava syndrome due to innominate vein stenosis.
Keywords: Superior vena cava syndrome, Innominate vein pressure, Peripherally inserted central venous catheter
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|How to Cite this Article: Saito K, Yamauchi M | Resection of Papillary Thyroid Carcinoma Occupying the Superior Vena Cava and Right Atrium under Cardiopulmonary Bypass in a Patient with Severe Superior Vena Cava Syndrome: A Case Report | Journal of Anaesthesia and Critical Care Case Reports | May-August 2023; 9(2): 01-04. https://doi.org/10.13107/jaccr.2023.v09i02.215|
Tags: Innominate vein pressure, Peripherally inserted central venous catheter, Superior vena cava syndrome