PMC8074681_01
(A) Thoracic computed tomography angiography, coronal reconstruction showing the tumour (red arrow) filling the superior vena cava lumen. (B) Thoracic magnetic resonance imaging T2 weighted, and (C) T1 weighted with gadolinium injection.
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Medical, Chicago, IL, USA) demonstrated an intraluminal heterogeneous mass in the SVC, extending from the left brachiocephalic venous trunk to the distal third of the SVC (Fig. 1A). T1 weighted and T2 weighted signal (Fig. 1B and C). The azygos vein had not been invaded.
(A) Post-operative schematic representation of the superior vena cava reconstruction with 1) 8 mm polytetrafluoroethylene graft and 2) 16 mm polytetrafluoroethylene graft. (B) Post-operative thoracic computed tomography angiography 3D reconstruction.
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Gore & Associates, Flagstaff, AZ, USA) sutured distally to the right atrium junction and proximally, perpendicularly on an 8 mm diameter ringed ePTFE prosthesis, connecting both right and left venous confluences (Fig. 2A).
(A) Macroscopic view of the superior vena cava specimen: the tumour was strictly intraluminal. (B) Histology of a transverse cross section of the tumour demonstrated an intravenous (venous wall [1]) mass obstructing the lumen (2) with lobular architecture and thrombotic re-organisation (3) (haematoxylin and eosin stain [H&E] x0.70). (C) Close up picture of the mass showed numerous small capillaries (arrows) and larger vessels (black stars) within fibro-oedematous stroma (black triangle) (H&E x10). (D) At higher magnification, capillaries showed unstratified endothelium without atypia (black arrow), accompanied by inflammatory cells (blue arrow) (H&E x20).
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Pathological examination showed a tumour measuring 55 x 34 x 25 mm, filling the SVC lumen (Fig. 3A and B). Microscopic analysis identified a vascular lesion with lobular architecture, consisting of multiple capillaries lining unstratified endothelium without atypia separated by a fibro-oedematous stroma (Fig. 3C and D).