Abstract
We are reporting a case of a 47-year-old male with primary synovial sarcoma of the right parotid gland with tumor thrombus extension in the right internal jugular vein and right atrium. The rarity of this occurrence as documented in the review of the literature provides for uncertainty about proper management. Our case represents a rare occurrence with the unique radiological finding that has implications for management.
Highlights
We report a case of primary synovial sarcoma of the parotid gland with direct i.v. thrombus extending down the right internal jugular vein into the right atrium, evident in the form of a filling defect with the expansion of right internal jugular vein documented with CT
CASE REPORT A 47-year-old male with no smoking, drinking, or no history of previous malignancy was initially referred to the department of radiodiagnosis for characterization of a growing painless right parotid mass that had been present for 1 year with rapid progression within three months
Six month before presenting to our institution, the patient had noticed a right neck mass for which MRI was done outside, which showed a well-circumscribed, heterogeneous mass with low signal intensity on T1W images and high intensity on T2W images, involving both superficial and deep lobe of the right parotid gland, closely abutting right internal carotid artery and right internal jugular vein and extending into the right para-p haryngeal space with no evidence of tumor thrombus noted at that time (Figure 1)
Summary
Tumor thrombus within neck veins is an uncommon event in the head and neck malignancies, and it has most often been reported in association with thyroid malignancies.[1,2,3,4,5,6,7] Here we report a case of primary synovial sarcoma of the parotid gland with direct i.v. thrombus extending down the right internal jugular vein into the right atrium, evident in the form of a filling defect with the expansion of right internal jugular vein documented with CT. Six month before presenting to our institution, the patient had noticed a right neck mass for which MRI was done outside, which showed a well-circumscribed, heterogeneous mass with low signal intensity on T1W images and high intensity on T2W images, involving both superficial and deep lobe of the right parotid gland, closely abutting right internal carotid artery and right internal jugular vein and extending into the right para-p haryngeal space with no evidence of tumor thrombus noted at that time (Figure 1). There was a history of rapid growth within 3 months With these clinical findings, the patient underwent a CT scan, which demonstrated a fairly large (6.2×4.4 cm) heterogeneously enhancing mass lesion with internal necrotic changes arising from the right parotid gland and involving both superficial and deep lobe with perilesional fat stranding. Patient died two months after the treatment was planned owing to the severity of the disease
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
