PMC8204692_01
Surgical detail of the SVC resection and reconstruction. (A) The bypass support from the internal jugular vein to the femoral vein. (B) The reconstruction of the SVC system with an EPTFE graft.
fsurg-08-644605-g0001.jpg
PMC8204692_03_fsurg-08-644605-g0001.jpg
F1
Although the diameter of pulmonary metastasis did not change significantly, there were clear cavities in the focus (Supplementary Figure 1), thus indicating that the focus responded well to apatinib.
CTA scan and intraoperative findings of patients. (A) Patient 1: A1-A3, an extended tumor thrombus totally occupied the left brachiocephalic vein and the SVC, near the right atrium (white arrow). A4, the resected vessels invaded by the tumor thrombus. (B) Patient 2: B1-B3, an extended tumor thrombus occupied the left brachiocephalic vein and the SVC, near the right atrium, but the obstruction of the SVC segment was incomplete (white arrow). B4, the resected vessels invaded by the tumor thrombus. (C) Patient 3: C1-C3, an extended tumor thrombus totally occupied the right brachiocephalic vein and the SVC, near to the right atrium (white arrow). C4, the resected vessels invaded by the tumor thrombus.
fsurg-08-644605-g0002.jpg
PMC8204692_03_fsurg-08-644605-g0002.jpg
F2
Further investigation with CTA (Figure 2C) showed that the mass of the right thyroid lobe invaded the initial segment of the esophagus and compressed the trachea. A thyroidectomy, a right central and lateral neck dissection, and an SVC reconstruction were performed, and the intraoperative findings were shown in Figure 2C.
PMC8204692_02
CTA scan and intraoperative findings of patients. (A) Patient 1: A1-A3, an extended tumor thrombus totally occupied the left brachiocephalic vein and the SVC, near the right atrium (white arrow). A4, the resected vessels invaded by the tumor thrombus. (B) Patient 2: B1-B3, an extended tumor thrombus occupied the left brachiocephalic vein and the SVC, near the right atrium, but the obstruction of the SVC segment was incomplete (white arrow). B4, the resected vessels invaded by the tumor thrombus. (C) Patient 3: C1-C3, an extended tumor thrombus totally occupied the right brachiocephalic vein and the SVC, near to the right atrium (white arrow). C4, the resected vessels invaded by the tumor thrombus.
fsurg-08-644605-g0002.jpg
PMC8204692_03_fsurg-08-644605-g0002.jpg
F2
Further investigation with CTA (Figure 2C) showed that the mass of the right thyroid lobe invaded the initial segment of the esophagus and compressed the trachea. A thyroidectomy, a right central and lateral neck dissection, and an SVC reconstruction were performed, and the intraoperative findings were shown in Figure 2C.
PMC8204692_03
Surgical detail of the SVC resection and reconstruction. (A) The bypass support from the internal jugular vein to the femoral vein. (B) The reconstruction of the SVC system with an EPTFE graft.
fsurg-08-644605-g0001.jpg
PMC8204692_03_fsurg-08-644605-g0001.jpg
F1
Although the diameter of pulmonary metastasis did not change significantly, there were clear cavities in the focus (Supplementary Figure 1), thus indicating that the focus responded well to apatinib.
CTA scan and intraoperative findings of patients. (A) Patient 1: A1-A3, an extended tumor thrombus totally occupied the left brachiocephalic vein and the SVC, near the right atrium (white arrow). A4, the resected vessels invaded by the tumor thrombus. (B) Patient 2: B1-B3, an extended tumor thrombus occupied the left brachiocephalic vein and the SVC, near the right atrium, but the obstruction of the SVC segment was incomplete (white arrow). B4, the resected vessels invaded by the tumor thrombus. (C) Patient 3: C1-C3, an extended tumor thrombus totally occupied the right brachiocephalic vein and the SVC, near to the right atrium (white arrow). C4, the resected vessels invaded by the tumor thrombus.
fsurg-08-644605-g0002.jpg
PMC8204692_03_fsurg-08-644605-g0002.jpg
F2
Further investigation with CTA (Figure 2C) showed that the mass of the right thyroid lobe invaded the initial segment of the esophagus and compressed the trachea. A thyroidectomy, a right central and lateral neck dissection, and an SVC reconstruction were performed, and the intraoperative findings were shown in Figure 2C.