Scintigraphic features of superior vena caval obstruction due to substernal non-toxic goitre

Abstract

Four men with clinical features of superior vena caval syndrome due to large substernal non-toxic multinodular goitre have undergone radionuclide superior vena caval studies. In all cases the dynamic scintigraphs showed a characteristic thyroidal configuration attributed to the definition of stretched thyroidal veins and their tributaries. Radiocontrast studies of two patients demonstrated the characteristic thyroid configuration. A radionuclide superior venacavogram taken post-thyroid lobectomy in one case showed the features had reverted to normal.

Superior vena cava syndrome presenting as persistent erythematous oedema of the face

“…SVCS with retrosternal goiter has been reported. 10–13 It is seen with thyroid carcinoma more frequently than with benign retrosternal goiter. Horner's syndrome due to thyroid disease may be seen in these patients.…”

Superior vena caval syndrome due to substernal goitre

“…In our first case phleboscintigraphy, or radionuclide venography of the superior vena cava, was helpful in demonstrating a total obstruction of the superior vena cava and the collateral circulation. Recently a review was given of findings using this method in 123 patients with clinical features of SVCS or demonstrating a parahilar or mediastinal mass [7]. It is a reliable and safe method of determining the site and extent of the obstruction and the collateral circulation.…”