Metastatic papillary thyroid carcinoma with internal jugular vein tumor thrombus - A case report and review of the literature

Papillary thyroid carcinoma (PTC) is the most common malignancy of the thyroid gland, typically associated with an indolent course and favourable prognosis. However, although rare, PTC can demonstrate aggressive behaviour, including vascular invasion with extension into major vessels. Intraluminal t...

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Main Authors: Zaina Adnan, Edmond Sabo, Sameer Kassem
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1505800/full
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author Zaina Adnan
Edmond Sabo
Sameer Kassem
author_facet Zaina Adnan
Edmond Sabo
Sameer Kassem
author_sort Zaina Adnan
collection DOAJ
description Papillary thyroid carcinoma (PTC) is the most common malignancy of the thyroid gland, typically associated with an indolent course and favourable prognosis. However, although rare, PTC can demonstrate aggressive behaviour, including vascular invasion with extension into major vessels. Intraluminal tumor thrombus involving the great veins, such as the internal jugular vein (IJV), is an uncommon but significant complication. We present the case of a 56-year-old male who was referred to our clinic for evaluation of a right-sided anterior neck mass. Neck ultrasonography revealed a 5.5 x 6.5 cm heterogeneous mass within the right thyroid lobe and a suspected intraluminal thrombus in the right internal jugular vein. Fine-needle aspiration biopsy under ultrasound guidance confirmed the diagnosis of papillary thyroid carcinoma. Subsequent preoperative contrast-enhanced computed tomography (CT) of the neck confirmed the presence of an intraluminal tumours thrombus extending into the right IJV. The patient underwent total thyroidectomy, right modified radical neck dissection, and resection of the involved segment of the IJV. Postoperatively, the patient received radioactive iodine (I-131) ablation therapy. At the one-year follow-up, imaging studies indicated a recurrence of the disease. A review of the literature focusing on vascular involvement in PTC and diagnostic methods for tumours thrombus reveals that, while rare, intraluminal tumor thrombus should be considered in patients with PTC, especially when there is evidence of vascular invasion. Early and accurate preoperative diagnosis using Doppler ultrasonography and/or contrast-enhanced CT is critical for optimal surgical planning and improved prognosis. Given the potential for recurrence, vigilant long-term follow-up is recommended.
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spelling doaj-art-e77e71f997da42d89756d0b2ac58dedb2025-01-29T05:21:30ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-01-011610.3389/fendo.2025.15058001505800Metastatic papillary thyroid carcinoma with internal jugular vein tumor thrombus - A case report and review of the literatureZaina Adnan0Edmond Sabo1Sameer Kassem2Department of Endocrinology and Metabolism, Clalit Medical Health Care Services, Haifa and Western Galilee District, Bar-Ilan Faculty of Medicine, Safed, IsraelThe Institute of Pathology, Carmel Medical Center, Ruth and Bruce Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, IsraelDepartment of Internal Medicine, Carmel Medical Center, Ruth and Bruce Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, IsraelPapillary thyroid carcinoma (PTC) is the most common malignancy of the thyroid gland, typically associated with an indolent course and favourable prognosis. However, although rare, PTC can demonstrate aggressive behaviour, including vascular invasion with extension into major vessels. Intraluminal tumor thrombus involving the great veins, such as the internal jugular vein (IJV), is an uncommon but significant complication. We present the case of a 56-year-old male who was referred to our clinic for evaluation of a right-sided anterior neck mass. Neck ultrasonography revealed a 5.5 x 6.5 cm heterogeneous mass within the right thyroid lobe and a suspected intraluminal thrombus in the right internal jugular vein. Fine-needle aspiration biopsy under ultrasound guidance confirmed the diagnosis of papillary thyroid carcinoma. Subsequent preoperative contrast-enhanced computed tomography (CT) of the neck confirmed the presence of an intraluminal tumours thrombus extending into the right IJV. The patient underwent total thyroidectomy, right modified radical neck dissection, and resection of the involved segment of the IJV. Postoperatively, the patient received radioactive iodine (I-131) ablation therapy. At the one-year follow-up, imaging studies indicated a recurrence of the disease. A review of the literature focusing on vascular involvement in PTC and diagnostic methods for tumours thrombus reveals that, while rare, intraluminal tumor thrombus should be considered in patients with PTC, especially when there is evidence of vascular invasion. Early and accurate preoperative diagnosis using Doppler ultrasonography and/or contrast-enhanced CT is critical for optimal surgical planning and improved prognosis. Given the potential for recurrence, vigilant long-term follow-up is recommended.https://www.frontiersin.org/articles/10.3389/fendo.2025.1505800/fullcase reportpapillary thyroid carcinomatumor thrombusdistant metastasisjugular veinenhanced CT
spellingShingle Zaina Adnan
Edmond Sabo
Sameer Kassem
Metastatic papillary thyroid carcinoma with internal jugular vein tumor thrombus - A case report and review of the literature
Frontiers in Endocrinology
case report
papillary thyroid carcinoma
tumor thrombus
distant metastasis
jugular vein
enhanced CT
title Metastatic papillary thyroid carcinoma with internal jugular vein tumor thrombus - A case report and review of the literature
title_full Metastatic papillary thyroid carcinoma with internal jugular vein tumor thrombus - A case report and review of the literature
title_fullStr Metastatic papillary thyroid carcinoma with internal jugular vein tumor thrombus - A case report and review of the literature
title_full_unstemmed Metastatic papillary thyroid carcinoma with internal jugular vein tumor thrombus - A case report and review of the literature
title_short Metastatic papillary thyroid carcinoma with internal jugular vein tumor thrombus - A case report and review of the literature
title_sort metastatic papillary thyroid carcinoma with internal jugular vein tumor thrombus a case report and review of the literature
topic case report
papillary thyroid carcinoma
tumor thrombus
distant metastasis
jugular vein
enhanced CT
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1505800/full
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AT sameerkassem metastaticpapillarythyroidcarcinomawithinternaljugularveintumorthrombusacasereportandreviewoftheliterature