PMC6305890_01
(A) Right upper extremity lymphoedema at presentation. Swelling of the dorsal surface of the hand. The skin is hyperkeratotic and presents verrucous cobblestone like papules (grade 3 lymphoedema). (B) Right upper extremity and breast lymphoedema. (C) Right upper extremity lymphoedema five weeks after thyroidectomy (grade 2).
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An 87 year old female patient presented with lymphoedema (grade 3) of the upper right extremity that progressed over the course of two years (Fig. 1A). On inspection, right breast lymphoedema (Fig. 1B) and a cervical mass were apparent.
(A) and (B) Axial and coronal CT images show a solid left thyroid mass (asterisk) compressing the mediastinal structures, in particular the lymphatic vessels, right lymphatic duct, and subclavian vein at the right superior thoracic outlet (arrow). (C) CT axial image showing right breast enlargement, fat stranding (asterisk), and skin thickening (arrow) reflecting the lymphoedema.
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The chest computed tomography scan (CT) revealed a solid left thyroid mass measuring 63x40x96 mm with mediastinal structure compression and deviation to the right (Fig. 2A and B).