Large thoracic tumour without superior vena cava syndrome

• Autorzy: Garmpis N. , Damaskos C. , Patelis N. , Dimitriulis D. , Spartalis E. , Tomos I. , Garmpi A. , Spartalis M. , Antoniou E.A. , Kontzoglou K. , Tomos P.
• Języki publikacji: EN

Abstrakty

EN

A 62-year-old male with long-standing smoking history presented with haemoptysis. Plain chest X-ray showed abnormal findings proximate to the right pulmonary hilum. Bronchoscopy revealed a fragile exophytic tumour of the right wall of the lower third of the trachea, infiltrating the right main bronchus (75% stenosis) and the right upper lobar bronchus (near total occlusion). Contrast-enhanced chest computed tomography demonstrated a 7.2 × 4.9 cm tumour contiguous to the above-mentioned structures, mediastinal lymph node pathology, and a vessel coursing inferiorly to the left of the aortic arch and anterior to the left hilum. Despite the tumour constricting the right superior vena cava (SVC), no signs of SVC syndrome were present. In this case, the patient does not present with SVC syndrome, as expected due to the constriction of the (right) SVC caused by the tumour, since head and neck veins drain through the persistent left superior vena cava (PLSVC). PLSVC is the most common thoracic venous anomaly with an incidence of 0.3% to 0.5% of the general population and it is a congenital anomaly caused by the failure of the left anterior cardinal vein to regress and to consequently form the ligament of Marshall during foetal development. It is associated with absence of the left brachiocephalic vein and in 10% to 20% of cases the right SVC is absent. Two potential draining points of the PLSVC have been previously reported. In the majority of cases PLSVC drains directly into the coronary sinus, but less frequently it drains into the left atrium or the left superior pulmonary vein (LSPV). In cases where the PLSVC drains into the coronary sinus, congenital heart defects are rare. The patient usually remains asymptomatic and PLSVC is an incidental finding during radiographic imaging or medical procedures. When the PLSVC drains into the left atrium or the LSPV, a right-to-left shunt is formed; a condition usually asymptomatic. In some reported cases this PLSVC variant presents with persistent, unexplained hypoxia or cyanosis and embolisation causing recurrent transient ischaemic attacks and/or cerebral abscesses. This PLSVC variant is more often associated with absence of the right SVC and congenital heart abnormalities. (Folia Morphol 2017; 76, 4: 748–751)

• Wydawca: -
• Czasopismo: Folia Morphologica
• Rocznik: 2017
• Tom: 76
• Numer: 4
• Opis fizyczny: p.748-751,fig.

Twórcy

autor

Garmpis N.

• 2nd Department of Propaedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece

autor

Damaskos C.

• 2nd Department of Propaedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece
• N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Greece

autor

Patelis N.

• 1st Department of Surgery, Vascular Division, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece

autor

Dimitriulis D.

• 2nd Department of Propaedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece

autor

Spartalis E.

• 2N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Greece

autor

Tomos I.

• 2nd Pulmonary Department, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, Greece

autor

Garmpi A.

• Internal Medicine Department, Laiko General Hospital, University of Athens Medical School, Athens, Greece

autor

Spartalis M.

• Division of Cardiology, Onassis Cardiac Surgery Centre, Athens, Greece

autor

Antoniou E.A.

• 2nd Department of Propaedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece

autor

Kontzoglou K.

• 2nd Department of Propaedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece

autor

Tomos P.

• Department of Thoracic Surgery, Attikon General Hospital, National and Kapodistrian University of Athens, Medical School, Chaidari, Greece

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Identyfikatory

DOI

10.5603/FM.a2017.0034