Thrombosis of the jugular vein with pulmonary embolisms as a cause of supraclavicular swelling

Introduction:

Tamoxifen is a selective modulator of estrogen receptors and applied in the treatment of breast cancer. In this connection it is known that pulmonary embolism may occur. Here we report of a case of a thrombosis of the jugular vein with additional embolic complications.

Methods:

The case of a female patient is described in detail as a case report, including the results of imaging procedures.

Results:

A 48-year-old female patient presented with a progressive swelling of the left supraclavicular cervical area. The swelling was soft to palpation and the external jugular vein showed stasis. There were no further complaints or pain and no signs of infection. After breast cancer treatment the patient was undergoing a therapy with tamoxifen. There were no pathological findings on physical examination. Sonographically a spherical anechoic mass around the internal jugular vein became apparent. A contrast-enhanced CT scan of the neck and thorax revealed a subtotal long-segment thrombosis of the left internal jugular vein and segmental pulmonary embolisms on both sides. The patient was transferred to the department of internal medicine for further testing and sufficient treatment.

Conclusions:

In the case of an unclear swelling of the neck region a detailed anamnesis is of fundamental importance. In addition, a complete diagnostic including imaging procedures is necessary. As one differential diagnosis thromboembolism has to be considered.

Publication History

Publication Date:
18 April 2018 (online)