{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:42Z","timestamp":1753876242067,"version":"3.41.2"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T00:00:00Z","timestamp":1651536000000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Primary thyroid leiomyosarcoma (LMS) is a very rare tumour with less than 40 published cases yet. Direct metastatic extension into the great cervical veins and caval veins is extremely uncommon. Extension to the right heart has not yet been reported.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 62-year-old man was admitted for sudden onset of left neck pain and dyspnoea. Computed tomography and ultrasonography found an extensive mass of the left great cervical veins, superior vena cava, and a nodule in the left thyroid lobe. Transesophageal echocardiography visualized large protrusion of this mass into the right atrium. Cytology of a thyroid nodule diagnosed a benign hyperplastic nodule. The mass was considered to be likely an extensive thrombus. The patient was started on anticoagulant therapy. The next course was complicated by pulmonary embolism and later by enterorrhagia. Despite clinical stabilization, the patient died suddenly. Autopsy finding differed from the clinical conclusion. Microscopic investigation revealed that the mass seen in the cervical veins down to the right atrium was a spindle cell tumour with a primary site in the left thyroid lobe. Immunohistochemistry was consistent with the final diagnosis of primary thyroid LMS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Differential diagnosis of the masses of great cervical veins and right atrium can be challenging. Pure venous thrombus and tumour thrombus must be distinguished. Thyroid LMS should also be considered in patients with masses in the right atrium and thyroid nodules.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytac193","type":"journal-article","created":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T16:44:20Z","timestamp":1651769060000},"source":"Crossref","is-referenced-by-count":3,"title":["Primary thyroid leiomyosarcoma with transvenous extension to the right atrium: a case report"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8064-6634","authenticated-orcid":false,"given":"Juraj","family":"Dubrava","sequence":"first","affiliation":[{"name":"Department of Cardiology, Ss. Cyril and Methodius Hospital, University Hospital Bratislava, Antolska 11, 85107 Bratislava, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2429-0375","authenticated-orcid":false,"given":"Peter","family":"Martanovic","sequence":"additional","affiliation":[{"name":"Department of Pathology, Ss. Cyril and Methodius Hospital, University Hospital Bratislava, 85107 Bratislava, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4786-9187","authenticated-orcid":false,"given":"Marina","family":"Pavlovicova","sequence":"additional","affiliation":[{"name":"Medical Imaging Department, Ss. Cyril and Methodius Hospital, University Hospital Bratislava, 85107 Bratislava, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8170-1850","authenticated-orcid":false,"given":"Pavel","family":"Babal","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Comenius University in Bratislava, 81108 Bratislava, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,5,3]]},"reference":[{"key":"2022051715252532500_ytac193-B1","doi-asserted-by":"crossref","first-page":"51","DOI":"10.11138\/gchir\/2018.39.1.051","article-title":"Primary thyroid leiomyosarcoma: a case report and review of the literature","volume":"39","author":"Canu","year":"2018","journal-title":"G Chir"},{"key":"2022051715252532500_ytac193-B2","doi-asserted-by":"crossref","first-page":"44","DOI":"10.17925\/EE.2019.15.1.44","article-title":"Primary leiomyosarcoma of the thyroid gland\u2014a rare malignancy","volume":"15","author":"Reddy","year":"2019","journal-title":"Eur Endocrinol"},{"key":"2022051715252532500_ytac193-B3","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/j.bjorl.2015.11.020","article-title":"Thyroid leiomyosarcoma: presentation of two cases and review of the literature","volume":"82","author":"\u015eahin","year":"2016","journal-title":"Braz J Otorhinolaryngol"},{"key":"2022051715252532500_ytac193-B4","doi-asserted-by":"crossref","first-page":"473","DOI":"10.12998\/wjcc.v7.i4.473","article-title":"Primary leiomyosarcoma of the thyroid gland with prior malignancy and radiotherapy: a case report and review of literature","volume":"7","author":"Vujosevic","year":"2019","journal-title":"World J Clin Cases"},{"key":"2022051715252532500_ytac193-B5","first-page":"1","article-title":"Primary thyroid leiomyosarcoma\u2014case report and literature review","volume":"3","author":"Cherry","year":"2019","journal-title":"Surg Rehabil"},{"key":"2022051715252532500_ytac193-B6","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1002\/(SICI)1097-0142(19970201)79:3<579::AID-CNCR22>3.0.CO;2-#","article-title":"Primary smooth muscle tumours of the thyroid gland","volume":"79","author":"Thompson","year":"1997","journal-title":"Cancer"},{"key":"2022051715252532500_ytac193-B7","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1089\/105072504773297885","article-title":"False-negative fine-needle aspiration cytology results delay treatment and adversely affect outcome in patients with thyroid carcinoma","volume":"14","author":"Yeh","year":"2004","journal-title":"Thyroid"},{"key":"2022051715252532500_ytac193-B8","doi-asserted-by":"crossref","first-page":"64","DOI":"10.4132\/jptm.2019.12.04","article-title":"2019 Practice guidelines for thyroid core needle biopsy: a report of the clinical practice guidelines development committee of the Korean thyroid association","volume":"54","author":"Jung","year":"2020","journal-title":"J Pathol Transl Med"},{"key":"2022051715252532500_ytac193-B9","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/S0009-9260(05)80580-X","article-title":"Case report: bilateral massive internal jugular vein thrombosis in carcinoma of the thyroid: CT evaluation","volume":"43","author":"Thomas","year":"1991","journal-title":"Clin Radiol"},{"key":"2022051715252532500_ytac193-B10","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.ijscr.2019.10.050","article-title":"Staged surgical management of follicular thyroid carcinoma with extensive thrombus reaching up to right atrium\u2014a case report","volume":"66","author":"Lad","year":"2020","journal-title":"Int J Surg Case Rep"},{"key":"2022051715252532500_ytac193-B11","doi-asserted-by":"crossref","first-page":"301","DOI":"10.4103\/wjnm.WJNM_43_18","article-title":"A rare case of minimally invasive follicular thyroid cancer with intraluminal superior vena cava and right atrium metastases","volume":"18","author":"Khoo","year":"2019","journal-title":"World J Nucl Med"},{"key":"2022051715252532500_ytac193-B12","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1080\/00016480500527193","article-title":"Leiomyosarcoma of the thyroid gland","volume":"128","author":"Mansouri","year":"2008","journal-title":"Acta Otolaryngol"}],"container-title":["European Heart Journal - 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