Description superior vena cava syndrome is a partial occlusion of the. Treatment depends on the etiology of the obstructive process. Pdf superior vena cava syndrome in thoracic malignancies. Superior vena cava syndrome is a form of vessel obstruction that occurs as a result of mechanical compression or due to thrombosis. Superior vena cava obstruction radiology reference. Superior vena cava syndrome symptoms, diagnosis and. Treatment of superior vena cava syndrome using angiojet. Superior vena cava syndrome svcs refers to the clinical syndrome with symptoms that results from this obstruction. In the preantibiotic era, the untreated infections were. In superior vena cava syndrome svcs, this vein has become obstructed or compressed to some degree. A patient with svcs requires immediate diagnostic evaluation and. Superior vena cava syndrome in children springerlink. Obtaining tissue diagnosis is important to confirm presence of malignancy. Superior vena cava syndrome possibilities of intervention therapy beran s.
It was first described by william hunter in 1757, in a patient with a large syphilitic aortic aneurysm compressing the svc3,5. Superior vena cava syndrome svcs is a relatively common sequela of mediastinal malignancies and may cause significant patient distress. Pdf superior vena cava in a patient with superior vena. Major veins major veins forming the superior vena figure 7. A 58yearold man presents with a 2week history of progressive dyspnea on exertion, neck swelling, decreased appetite, and fatigue. Symptoms include facial edema, dyspnea, cough, neck distension, hoarseness and dysphagia, while severe cases may present with coma and severe respiratory distress. Hyperacute superior vena cava syndrome associated with central. The superior vena cava syndrome svcs comprises various symptoms due to occlusion of the svc, which can be easily obstructed by pathological conditions eg, lung cancer, due to the low internal venous pressure within rigid structures of the thorax trachea, right bronchus, aorta. It is a medical emergency and most often manifests in patients with a malignant disease process within the thorax. The superior vena cava is a large vein located in the upper chest, which collects blood from the head and arms and delivers it back to the right atrium of the heart.
Collateral pathways in superior vena cava obstruction as seen on gamma br j radiol 1982. The superior vena cava syndrome is the group of symptoms that result from compression of the large vein superior vena cava that transmits blood to the heart. Superior vena cava syndrome investigations bmj best. Pdf the superior vena cava syndrome svcs comprises various symptoms due to. Malignancies primarily lung cancer are the underlying cause of 8085% of cases, leaving 1520% caused by various benign conditions, including sclerosing. For example, obstruction of the superior vena cava svc may lead to the signs and symptoms of svc syndrome eg, headache, facial swelling, while obstruction of the esophagus venous thrombosis and thromboembolism in children.
A reassessment of the clinical applications of the superior vena cava syndrome. The superior vena cava syndrome svcs is defined as the set of signs and symptoms derived from superior vena cava obstruction, both intrinsic obstruction and extrinsic compression, which causes an increase in venous pressure in the upper. Congenital or acquired abnormalities can affect the diameter of svc. A case study of a patient who developed superior vena cava syndrome following radiofrequency ablation of the sinoatrial and atrioventricular nodes, and pacemaker implantation. Superior vena cava syndromea proposed classification system and. Superior vena cava svc syndrome is a collection of clinical signs and symptoms. Nonmalignant causes are increasing in prevalence due to expanding use of intravascular devices, which can result in thrombosis. The severity of the signs and symptoms presented depends on. It transports blood from our arms, chest, neck, and head to our hearts.
Superior vena cava syndrome svcs is rare in children. Review of evolving etiologies, implications and treatment. Case of duplicate superior vena cava and interrupted inferior vena cava hagans et al. Congenital or acquired abnormalities can affect the. Superior vena cava syndrome discharge care what you. Superior vena cava syndrome svcs develops when your superior vena cava is partially or fully blocked. We are writing in response to the brief report entitled superior vena cava syndrome due to nonsmallcell lung cancer by citron. Michael mcfadden the superior vena cava and its important intrathoracic venous tributaries are located in a tight compartment within the superior mediastinum, immediately adjacent and anterior to the trachea and right main bronchus. Superior vena cava syndrome is caused by advanced cancers arising in or invading the mediastinum, subsequently obstructing the venous drainage of the head, neck, and upper thoracic regions. Bronchoscopy has a diagnostic yield of 50% to 70%, transthoracic needleaspiration biopsy has a yield of approximately 75%, and mediastinoscopy or mediastinotomy has a diagnostic yield of 90%. Superior vena cava svc syndrome was originally described as being secondary to an infection. The photograph shows massive engorgement of collateral subcutaneous veins of the chest and abdomen in a 58year. Once the thoracic imaging is obtained, the workup should include brain, abdominal and bone studies in view of the probable malignant nature of the primary lesion.
Superior vena cava syndrome svcs is obstruction of blood flow through the superior vena cava svc. Currently, it is almost exclusively secondary to malignancy. Superior vena cava svc syndrome is a clinical condition that occurs as a result of obstruction of the svc, leading to interrupted venous return from the head, thorax, and. Nonhodgkins lymphoma nhl is the most common cause of svcs in children. A patient with svcs requires immediate diagnostic evaluation and therapy.
The resulting increased venous pressure in the upper body may cause. Superior vena cava syndrome svcs is mechanical obstruction of the superior vena cava svc due to venous thrombi or extrinsic compression by intrathoracic tumours in most cases. The syndrome was originally described as being secondary to an infection, such as tuberculosis, or a syphilitic aortic aneurysm 24. Superior vena cava syndrome an overview sciencedirect. The most common cause of superior vena cava syndrome is cancer. Superior vena cava syndrome svc syndrome slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. In anatomy, a persistent left superior vena cava plsvc is the most common variation of the thoracic venous system, is prevalent in 0. A case of svc syndrome presenting with dyspnea, facial swelling, neck distension and cough developed over a period of 10 days is reported. This report an adolescent male who presented with svcs due to mixed germ cell tumor gct of the anterior mediastinum with predominant yolk cell component. Superior vena cava syndrome svcs, a clinical manifestation arising from compression of the thinwalled superior vena cava svc, was first described by william hunter in 1757 and can be caused by a variety malignancies hunter and johnston 1757. Bilyeu, md approximately 15,000 cases of superior vena cava svc obstruction are diagnosed in the united states annually.
Treatment should also be individualized and should. Superior vena cava syndrome with malignant causes nejm. Superior vena cava svc syndrome is classically thought of as a. Malignancies are the main cause and are considered an oncologic emergency. Superior vena cava syndrome svcs is a group of symptoms that can occur in people who have lung cancer, lymphoma, or other cancers that involve the center of the chest. Superior vena cava svc obstruction can occur from extrinsic compression, intrinsic stenosis, or thrombosis. No matter where you are in your career, we would welcome you and encourage you to consider joining our community. Superior vena cava svc syndrome occurs in approximately 15,000 people in the united states each year. Superior vena cava syndrome is diagnosed by ultrasound, chest xray, ct scan, and in some cases biopsy. An intrathoracic malignancy is responsible for 60 to 85 percent of cases of superior vena cava syndrome svc syndrome, and svc obstruction is the presenting overview of the risk factors, pathology, and clinical manifestations of lung cancer view in chinese. Superior vena cava syndrome in thoracic malignancies. Svcs is a medical emergency if associated with laryngeal or cerebral edema. Clarkepearson md, in clinical gynecologic oncology ninth edition, 2018.
William hunter first described the syndrome in 1757 in. The diagnosis can be made clinically, but imaging studies are. Causes of superior vena cava include lung cancer, lymphoma, other cancers in the chest, blood clots in the superior vena cava, or. A restriction of the blood flow occlusion through this vein can cause superior vena cava syndrome svcs. Case of duplicate superior vena cava and interrupted.
Svcs is a significant disorder affecting up to 10 % of small cell lung cancer sclc patients and 24 %. The syndrome is rarely an oncologic emergency in the absence of tracheal compression and airway compromise. Primary or metastatic cancer in the upper lobe of the right lung can compress the superior vena cava. Superior vena cava syndrome is a relatively rare presentation in which. Lung cancer is the most common cause of superior vena cava syndrome svcs and requires timely recognition and management. Complications such as postoperative asymptomatic pulmonary embolism, filter migration, and superior vena cava syndrome did not occur in any of the. Epidemiology svcs develops in about 510% of patients with. Superior vena cava syndrome, is a group of symptoms caused by obstruction of the superior vena cava, a short, wide vessel carrying circulating blood into the heart. The etiologies and management of svcs have evolved over time. Blood from your upper body normally flows through the superior vena cava and into the right side of your heart. Lymphoma or other tumors located in the mediastinum can also cause compression of the superior vena cava less often, the superior vena cava can become blocked with a blood clot from within. Symptoms of the syndrome include shortness of breath. If you continue browsing the site, you agree to the use of cookies on this website. Treatment of malignant superior vena cava syndrome by.
Superior vena cava svc syndrome has a characteristic and often striking. Superior vena cava syndrome svcs is rare in childhood. Superior vena cava syndrome definition of superior vena. Currently, svc syndrome is generally due to cancer or thrombotic events. The superior vena cava is one of the primary veins within our bodies.
Superior vena cava syndrome svcs is a medical emergency which consists of the obstruction of blood flow through the superior vena cava. Pdf treatment of superior vena cava syndrome researchgate. Definition the superior vena cava is the major vein in the chest that carries blood from the upper part of the body in to the heart. However, most examples in the literature combine percutaneous. If this vein is compressed by outside structures, or if a thrombus or clot develops within it, return blood flow to the heart is impeded. Lymph nodes that drain the entire right chest and lower portion of. Superior vena cava obstruction evaluation with mdct ajr. Diagnosis could be confirmed in 17 cases as one child succumbed to severe respiratory distress without a definitive diagnosis. Risk factors, clinical manifestations, and diagnosis view in chinese.