tailieunhanh - Báo cáo y học: " Persistent left superior vena cava mistaken for nodal metastasis: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Persistent left superior vena cava mistaken for nodal metastasis: a case report. | Tzilas et al. Journal of Medical Case Reports 2010 4 174 http content 4 1 174 jA CASE REPORTS CASE REPORT Open Access Persistent left superior vena cava mistaken for nodal metastasis a case report VasiliosTzilas Antonios Bastas Aspasia Koti Dimitra Papandrinopoulou and GeorgiosTsoukalas Abstract Introduction Evaluation of the mediastinum is crucial for patients with lung cancer. Mediastinal lymph node metastases play a dramatic role in the process of staging. Physicians should be aware of the potential pitfalls regarding mediastinal evaluation. This case report provides an example. Case presentation We report the case of a 57-year-old Caucasian man who presented with a four-month history of non-productive cough. He was diagnosed with non-small cell lung cancer. Initially it was thought to be inoperable due to the presence of a para-aortic lymph node. A more careful examination of the mediastinum revealed that the lymph node was in fact a persistent left superior vena cava. Conclusions This study highlights the difficulties in mediastinal staging especially when intravenous contrast is not used. The recognition of this vascular malformation dramatically changed the therapeutic decisions giving our patient the opportunity of surgical resection. To the best of our knowledge such correlation has not been described in English literature. Introduction Persistent left superior vena cava PLSVC is a rare vascular abnormality. It is however the most frequent abnormality of the mediastinal veins. The prevalence is estimated to be in the general population. It is higher up to in cases of congenital heart disease 1 2 . The key point for diagnosis is the identification of the course of the aberrant vessel. It begins from the left bran-chiocephalic vein at the junction of the left subclavian and internal jugular veins which is usually hypoplastic 65 . In 10 to 18 of cases there is absence of the right superior vena cava. PLSVC