A Rare Cause of Upper Limb Lymphoedema

Area of Science:

• Oncology
• Vascular Surgery
• Endocrinology

Background:

• Upper extremity lymphoedema is a debilitating condition often associated with cancer treatment or infection.
• Thyroid tumors are typically associated with endocrine dysfunction or airway compression, not peripheral lymphoedema.
• This case presents a novel etiology for lymphoedema, highlighting the importance of thorough investigation in complex cases.

Purpose of the Study:

• To report the first documented case of upper extremity lymphoedema secondary to a thyroid tumor.
• To elucidate the mechanism by which a thyroid tumor can cause extensive lymphatic obstruction.
• To demonstrate the efficacy of surgical intervention in resolving tumor-induced lymphoedema.

Main Methods:

• A detailed clinical case presentation of an 87-year-old female with severe, chronic upper extremity lymphoedema.
• Diagnostic workup including imaging to identify the cause of mediastinal compression.
• Surgical management via thyroidectomy to address the underlying thyroid tumor.

Main Results:

• The patient presented with Grade 3 right upper extremity lymphoedema of two years' duration.
• Imaging revealed a thyroid tumor compressing mediastinal structures at the right superior thoracic outlet.
• Post-thyroidectomy, significant improvement in lymphatic oedema was observed, indicating successful decompression.

Conclusions:

• Thyroid tumors can, albeit rarely, cause upper extremity lymphoedema through extrinsic compression of mediastinal vasculature and lymphatic pathways.
• Surgical resection of the causative thyroid tumor is an effective treatment for this specific type of lymphoedema.
• This case underscores the need to consider uncommon etiologies in the differential diagnosis of severe lymphoedema.