INTRAVASCULAR LIPOMA OF THE RIGHT BRACHIOCEPHALIC VEIN AND SUPERIOR VENA CAVA: A CASE REPORT AND LITERATURE REVIEW

Lipomas of the major central veins are very rare tumors that have mostly been described in the inferior vena cava. They may be identified in as many as 0.5% of all CT scans. Intravenous lipoma of the right brachiocephalic vein end vena cava superior is a rare tumor. There are only sixteen other case reported in medical literature. A rare case of superior vena cava (SVC) lipoma and literature review are presented. A 53-year-old woman with oedema of face and hand and history of chest trauma underwent computed tomography of the chest. Unenhanced CT showed a hypodense elongated lesion with fat density within the SVC. Surgical resection of the lesion was performed and histopathological evaluation confirmed the diagnosis of SVC lipoma. Intravascular lipomas may be asymptomatic, or they may induce venous obstructive symptoms, including upper limb swelling. Surgical removal of intravenous lipoma is recommended in both symptomatic and asymptomatic patients to rule out malignancy, to prevent obstruction of the SVC, penetration of the right atrium, and thromboembolic complications. Surgery for intravascular tumors must be safe and complete. Combined partial transsternal and supraclavicular approach allows to control all the major thoracic veins and avoids pulmonary embolism, minimizes bleeding, and allows en bloc resection of the tumor.