Retrosternal goiter presenting as deep vein thrombosis of the arm.

INTRODUCTION

Deep vein thrombosis of the upper-extremity (ueDVT) is often caused by trauma to the subclavian vein, central venous line and hypercoagulation disorders.

CASE REPORT: We present a case of a ueDVT due to retrosternal goiter compressing the right brachiocephalic vein. Low molecular weight heparin was initiated subcutaneously and fluid was aspirated from the thyroid cyst causing an immediate improvement. Cytology detected no malignancy. At eight-month follow-up, the patient showed complete resolution of her symptoms.

DISCUSSION: In general, the optimal treatment should include removal of the compressing thyroid. In co-morbid patients and a dominant thyroidal cyst, thyroid aspiration may be sufficient.