DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20182516

Superior vena cava syndrome: a case report of a rare form of presentation

Bijaya K. Behera, Vishnu K., Jaison George, Susanta K. Nahak

Abstract


Superior vena cava syndrome (SVCS) is the clinical manifestation of superior vena cava (SVC) obstruction, with severe reduction in venous return from the head, neck and upper extremities. It is a medical emergency. Obstruction to the SVC may be caused by neoplastic invasion of the venous wall associated with intravascular thrombosis or, more simply, by extrinsic pressure of a tumour mass against the relatively thin-walled SVC. More than 80% cases of SVCS are caused by malignant mediastinal tumours. We present a 42-year-old female patient who was admitted with 15 days history of swelling of face, neck and upper limbs and dyspnea of 5 days duration at MKCG Medical College Hospital, Berhampur, Odisha, India. The patient was diagnosed as a case of Non-Hodgkin's Lymphoma (NHL) which is a rare form of presentation. In this case report we would like to highlight that although lung carcinoma being the most common cause of acute superior vena cava syndrome, other malignancies like NHL should also be kept in mind and the importance of a detailed history, clinical examination and thorough investigations cannot be over emphasised.


Keywords


Contrast enhanced computed tomography, Fine needle aspiration cytology, Non-Hodgkin's lymphoma, Superior vena cava syndrome

Full Text:

PDF

References


Gucalp R, Dutcher JP. Oncologic emergency. In: Harrisons Principles of Internal Medicine. 19th ed. Mc Graw-Hill Education USA. 2015;2(19):1787.

Devarakonda S, Morgensztern D, Govindan R. Superior Vena Cava Syndrome. In: The Washington Manual of Medical Therapeutic. 35th ed. Wolters Kluwer (India) 2016;(35):724.

Plekker D, Ellis T, Irusen EM, Bolliger CT, Diacon AH. Clinical and radiological grading of superior vena cava obstruction. Respiration. 2008;76:69-75.

Hassikou H, Bono W, Bahiri R, Abir S, Benomar M, Hassouni NH. Vascular involvement in Behçet’s disease. Two case reports. Joint Bone Spine. 2002 Jun 1;69(4):416-8.

Baltayiannis N, Magoulas D, Anagnostopoulos D, Bolanos N, Sfyridis P, Georgiannakis E, Zografos P, Kayia A, Kayianni E, Sotirakoglou K, Chatzimichalis A. Percutaneous stent placement in malignant cases of superior vena cava syndrome. J BU ON.: official J Balkan Union Oncology. 2005;10(3):377-80.

Hunter W. The history of an aneurysm of the aorta with some remarks on aneurysms in general. Med Obs Enq. 1757;1:323-57.

Schechter MM. The superior vena cava syndrome. Am J Med Sci. 1954;227(1):46-56.

Armstrong BA, Perez CA, Simpson JR, Hederman MA. Role of irradiation in the management of superior vena cava syndrome. Inter J Radiation Oncol Biol Physics. 1987 Apr 1;13(4):531-9.

Escalante CP. Causes and management of superior vena cava syndrome. Oncology (Williston Park, NY). 1993;7(6):61-8.

Schraufnagel DE, Hill R, Leech JA, Pare JA. Superior vena caval obstruction is it a medical emergency?. Am J Med. 1981 Jun 1;70(6):1169-74.

Klassen KP, Andrews NC, Curtis GM. Diagnosis and treatment of superior-vena-cava obstruction. AMA Arch Surg. 1951;63(3):311-25.

Flounders JA. Oncology emergency modules: superior vena cava syndrome. Oncol Nurs Forum. 200330(4):E84-90.

Sakura M, Tsujii T, Yamauchi A, Tadokoro M, Tsukamoto T, Kawakami S, et al. Superior vena cava syndrome caused by supraclavicular lymph node metastasis of renal cell carcinoma. Inter J Clin Oncol. 2007 Oct 1;12(5):382-4.

Nieto AF, Doty DB. Superior vena cava obstruction: clinical syndrome, etiology, and treatment. Curr Prob Cancer. 1986;10(9):441-84.

Lochridge SK, Knibbe WP, Doty DB. Obstruction of the superior vena cava. Surgery. 1979;85(1):14-24.

Bigsby R, Greengrass R, Unruh H. Diagnostic algorithm for acute superior vena caval obstruction (SVCO). J Cardiovasc Surg (Torino). 1993;34(4):347-50.

Parish JM, Marschke RF Jr, Dines DE, Lee RE. Etiologic considerations in superior vena cava syndrome. Mayo Clin Proc. 1981;56(7):407-13.

Marcy PY, Magne N, Bentolila F, Drouillard J, Bruneton JN, Descamps B. Superior vena cava obstruction: is stenting necessary?. Supportive care in cancer. 2001 Mar 1;9(2):103-7.

Akoglu H, Yilmaz R, Peynircioglu B, Arici M, Kirkpantur A, Cil B, et al. A rare complication of hemodialysis catheters: superior vena cava syndrome. Hemodialysis International. 2007 Oct 1;11(4):385-91.

Nieto AF, Doty DB. Superior vena cava obstruction: clinical syndrome, etiology, and treatment. Curr Probl Cancer. 1986;10(9):441-84.