Overview
Superior vena cava syndrome (SVCS) is an array of symptoms caused by the
impairment of blood flow through the superior vena cava (SVC) to the right
atrium. Symptoms that prompt suspicion of this syndrome include dyspnea,
coughing, and swelling of the face, neck, upper trunk and extremities. In rare
instances, patients may complain of hoarseness, chest pain, dysphagia, and
hemoptysis. Physical signs that may be noted on presentation are neck vein
distention, thoracic vein distention, edema of the face or upper extremities,
plethora, and tachypnea. Rarely, cyanosis, Horner’s syndrome, and a paralyzed
vocal cord may also be present.[1]
SVCS is usually a sign of locally advanced bronchogenic carcinoma. Survival
depends on the status of the patient’s disease. When small cell bronchogenic
carcinoma is treated with chemotherapy, the median survival times with or
without SVCS are almost identical (42 weeks or 40 weeks). The 24-month
survival is 9% in patients without SVCS and 3% in those with the syndrome.
When the malignancy is treated with radiation therapy, 46% of patients who have
non-small cell lung cancer experience relief of symptoms compared with 62% of
patients who have small cell bronchogenic carcinoma. The 2-year survival of 5%
is almost the same for both groups.[2]
Most non-Hodgkin’s lymphoma patients with SVCS respond to appropriate
chemotherapy or to combined modality regimens.
References
- Gauden SJ: Superior vena cava syndrome induced by bronchogenic carcinoma: is this an oncological emergency? Australas Radiol 37 (4): 363-6, 1993.
[PUBMED Abstract]
- Urban T, Lebeau B, Chastang C, et al.: Superior vena cava syndrome in small-cell lung cancer. Arch Intern Med 153 (3): 384-7, 1993.
[PUBMED Abstract]
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