Thromb Haemost 2019; 119(04): 512-514
DOI: 10.1055/s-0039-1677712
T&H Images
Georg Thieme Verlag KG Stuttgart · New York

Superior Vena Cava Cancerous Thrombus Due to Squamous Cell Tongue Cancer: Virchow's Triad at Its Worst Version

John Papanikolaou
1   Department of Cardiology, General Hospital of Trikala, Thessaly, Greece
2   Department of Critical Care, University Hospital of Larissa, Thessaly, Greece
,
Triantafyllia Koukoubani
3   Department of Critical Care, General Hospital of Trikala, Thessaly, Greece
,
Epaminondas Zakynthinos
2   Department of Critical Care, University Hospital of Larissa, Thessaly, Greece
› Author Affiliations
Funding None.
Further Information

Publication History

22 August 2018

21 December 2018

Publication Date:
11 February 2019 (online)

Abstract

Superior vena cava (SVC) cancerous thrombosis is extremely sparse, especially in the setting of extrathoracic tumours. Herein, we present the case of a patient with a squamous cell carcinoma of the tongue, who presented with SVC syndrome possibly secondary to symptomatic metastatic pericardial effusion. In this unique patient, the disastrous concurrence of all the elements of Virchow's triad within the confined anatomical space of SVC may have precipitated extensive vessel thrombosis with catastrophic consequences. To our knowledge, there has been no previous report about presence of SVC cancerous thrombosis in squamous cell tongue cancer. In this respect, our report may provide an unusual mechanism of tongue cancer expansion, which clinicians should be familiar with. In addition, it may highlight the clinical importance of SVC thrombosis on patients' clinical outcome, as well as the role of transoesophageal echocardiography in early detection of occult thrombi in the sub-set of patients with SVC syndrome.

Authors' Contributions

J.P. and E.Z. conceived the study. J.P., T.F. and E.Z. participated in the acquisition and interpretation of data, drafted and critically revised the manuscript for important intellectual content. All authors read and approved the final manuscript.


 
  • References

  • 1 Kraft C, Schuettfort G, Weil Y. , et al. Thrombosis of the inferior vena cava and malignant disease. Thromb Res 2014; 134 (03) 668-673
  • 2 Wilson LD, Detterbeck FC, Yahalom J. Clinical practice. Superior vena cava syndrome with malignant causes. N Engl J Med 2007; 356 (18) 1862-1869
  • 3 Bagot CN, Arya R. Virchow and his triad: a question of attribution. Br J Haematol 2008; 143 (02) 180-190
  • 4 Rivkin A, Meara JG, Li KK, Potter C, Wenokur R. Squamous cell metastasis from the tongue to the myocardium presenting as pericardial effusion. Otolaryngol Head Neck Surg 1999; 120 (04) 593-595
  • 5 Kimura T, Chino M, Ogasawara N, Nakano T, Izumi S, Takeuchi H. Trousseau's syndrome with brachiocephalic vein thrombosis in a patient with uterine carcinosarcoma. A case report. Angiology 1999; 50 (06) 515-518