Insular carcinoma of the thyroid with jugular vein invasion

BACKGROUND: Gross angioinvasion with intraluminal tumor thrombus is rarely seen in thyroid cancer, with few cases reported in the literature. METHODS: We report an insular carcinoma of the thyroid displaying this aggressive local invasion and angioinvasion of the internal jugular chain. Complete surgical removal of the intraluminal disease, regional metastasis, and primary tumor was carried out. RESULTS: Adjuvant external beam radiation therapy and iodine-131 were administered, and the patient died with pulmonary metastases 30 months after surgery. No locoregional recurrence was noted at last follow-up. CONCLUSIONS: Treatment of insular carcinoma of the thyroid with invasion of the internal jugular vein is amenable to surgical resection. Postoperative radioactive iodine and external beam radiotherapy can achieve locoregional disease control and prolonged survival.