Superior vena cava syndrome due to Bronchogenic carcinoma
Superior vena cava syndrome (SVCS) is characterized by gradual, insidious compression/obstruction of the superior vena cava (SVC).
ETIOLOGY:
-Bronchogenic carcinoma (CA) accounts for more than 80% of cases of SVCS.
-Lymphoma accounts for approximately 15% of cases.
-Tuberculosis
-Dialysis catheters and pacemaker leads are becoming associated with SVCS
due to thrombosis.
Age:
Because the majority of SVC syndromes are caused by bronchogenic carcinoma, the age distribution is skewed strongly toward elderly persons.
Nonmalignant causes, as well as lymphoma, tend to affect younger people more than malignancy-associated SVCS.
SYMPTOMS
-Dyspnoea is the most common symptom, followed by trunk or extremity swelling
-Facial swelling
-Cough
-Orthopnea
-Headache
-Nasal stuffiness
The diagnosis of superior vena cava syndrome (SVCS) is often made on clinical grounds alone, combining clinical presentation with an often-obtained history of thoracic malignancy.
IMAGING:
Plain radiographs are often helpful, showing a mediastinal mass in most patients
When in doubt, venography can aid in the diagnosis, but this is usually not necessary.
Thoracic CT scanning is helpful, but remember that the histologic diagnosis is important in initiating therapy
MANAGEMENT
Steroids and diuretics have been the mainstays of emergency management.
Endoprostheses have become the initial choice for palliative treatment of superior vena cava syndrome.
After a tissue diagnosis, radiation and chemotherapy may be initiated.
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