Surgical Resection of an Intravascular Lipoma of the Superior Vena Cava

Figures

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  A voluminous hypodense mass fills the lumen of the superior vena cava.

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  Figure 1. Preoperative computed tomography in venous phase. A voluminous hypodense mass fills the lumen of the superior vena cava in its cranial extent up to the brachiocephalic vein confluence. The yellow dotted line shows the edges of the mass. Red points mark the stasis of contrast agent in the supracaval veins.

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  Figure 2. Operative outlines. A, The aorta (1) is visible under the left brachiocephalic vein (2), secured with a red vessel loop. The tumor (3) can be seen through the wall of the superior vena cava (outlined by a yellow dotted line) and determines a clear occlusion of the proximal venous axes above can be recognized. B, Venotomy completed and intraluminal mass excised. C, Resected mass of almost 9 × 5 cm. D, Postoperative reconstruction of the venous structures.

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  Figure 3. Follow-up computed tomography postoperatively. No residual tumor is visible.

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  Figure 4. Histologic analysis. A, Detail of lipoma tissue: no cellular atypia, pleomorphism, lipoblasts, or necrosis are detectable. B, MDM2 staining, showing completely negative nuclear expression.