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Case Reports
. 2016 Apr 19;2016(4):rjw044.
doi: 10.1093/jscr/rjw044.

Superior vena cava syndrome from an invasive thymoma with transcaval invasion to the right atrium

Ashwad Afzal  1 , Ivan Wong  1 , Aleksandr Korniyenko  2 , Alex Ivanov  2 , Berhane Worku  3 , Iosif Gulkarov  4
Affiliations
Case Reports

Superior vena cava syndrome from an invasive thymoma with transcaval invasion to the right atrium

Ashwad Afzal et al. J Surg Case Rep. .

Abstract

Invasive thymoma with transcaval extension to the right atrium is a rare cause of superior vena cava syndrome. We present a case on a 74-year-old female presenting with dyspnea on exertion, and facial and upper extremity swelling. Physical examination revealed mild facial swelling, non-pitting edema involving the upper extremities and distention of superficial veins of the anterior chest wall and jugular veins. An echocardiogram showed moderate right atrial dilation with a mobile mass in the atrial cavity prolapsing through the tricuspid valve. Cardiac magnetic resonance imaging revealed a 9.9 × 4.3 cm heterogeneous mass in the anterior mediastinum compressing the superior vena cava and endovenously extending into the right atrium. Tissue biopsy of the mediastinal mass revealed a type B1 thymoma, further staged as a Masaoka IVa invasive thymoma that underwent successfulen blocresection followed by removal of intracaval and right atrial mass.

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Figures

Figure 1:
Figure 1:
CMR sagittal view: large anterior mediastinal mass with extension into the right atrium.
Figure 2:
Figure 2:
CMR coronal view: anterior mediastinal mass invading superior vena cava and extending into the right atrium.
Figure 3:
Figure 3:
CMR axial four-chamber view: mass in the right atrial cavity protruding through the tricuspid valve into the right ventricle.
See this image and copyright information in PMC

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