Venous return from the lower half, below the diaphragm, flows through the. Superior vena cava syndrome affects 15,000 patients each year in the united states, and its incidence continues to grow as the prevalence of intravascular devices increases. The treatment of superior vena cava syndrome is directed toward the exact underlying cause. Malignancies primarily lung cancer are the underlying cause of 8085% of cases, leaving 1520% caused by. The increased venous pressure results in edema of the head, neck, and arms. Introduction superior vena cava svc syndrome results from any condition that leads to obstruction of blood flow through the svc. Its etiology has changed over time, it used to be due to infectious causes syph.
Stent placement in superior vena cava syndrome patrick courtheoux, md, barbara alkofer, md, madjed al refa. Thrombosis of the superior vena cava, however, is less common when it is not related to central venous catheters in the subclavian vein or the superior vena cava. We present the case of a patient with behcets disease which was discovered during a superior vena cava syndrome. Diagnosis could be confirmed in 17 cases as one child succumbed to. Since its first description in 1757, the superior vena cava syndrome has been a challenge for the clinician. Superior vena cava and the azygos system clinical anatomy. 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. Superior vena cava syndrome svcs is a medical condition which consists of the obstruction of blood flow through the superior vena cava. 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. Superior vena cava obstruction evaluation with mdct. The superior vena cava is a large vein that transmits blood from the upper body back to the heart. Superior vena cava syndrome svcs is rare in childhood. The syndrome is rarely an oncologic emergency in the absence of tracheal compression and airway compromise.
Both benign and malignant processes can cause superior vena cava syndrome. Svcs consists of symptoms and signs resulting from partial or complete obstruction of blood flow within the superior vena cava. Malignancy is the most common cause of the superior vena cava svc syndrome. 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. Most cases are caused by underlying intrathoracic malignancy, of which up to 95% are due to lung cancer or nonhodgkins lymphoma. The treatment of choice is irradiation, but in resistant cases or in. H j kim, h s kim, s h chung american journal of roentgenology. 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. If you continue browsing the site, you agree to the use of cookies on this website.
Superior vena cava syndrome secondary to aortic disease. Vascular thrombosis, especially venous, is common in this condition and also constitutes a basic diagnostic criterion. The majority of our patients were from 30 to 40 years of age, and 10 of our 16patients were women. A reassessment of the clinical applications of the superior vena cava syndrome. The superior vena cava vcs is located in the anterior mediastinum, he carries venous blood from head, neck, upper extremities and upper. The majority of cases are caused by malignant tumors within the mediastinum, most commonly lung cancer and nonhodgkins lymphoma, directly compressing or invading the svc wall. Superior vena cava syndrome revealing a behletls disease. Appropriate imaging techniques are important to confirm the diagnosis and rule out other causes of svc syndrome. Superior vena cava syndrome statpearls ncbi bookshelf. Its affection of the superior vena cava is rather rare with only a few cases described in the literature. Svcs is a significant disorder affecting up to 10 % of small cell lung cancer sclc patients and 24 % of all lung cancer patients. Feb 29, 2016 superior vena cava syndrome svcs is a relatively common sequela of mediastinal malignancies and may cause significant patient distress. The superior vena cava is one of the primary veins within our bodies.
It is a largediameter 24 mm short length vein that receives venous return from the upper half of the body, above the diaphragm. 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. The clinical diagnosis of svc syndrome is based largely on history and physical examination. Superior vena cava syndrome definition of superior vena. By definition it is the extrinsic or intrinsic obstruction of the superior vena cava. Superior vena cava svc syndrome is a collection of clinical signs and symptoms resulting from either partial or complete obstruction of blood. A restriction of the blood flow occlusion through this vein can cause superior vena cava syndrome svcs. Dec 27, 2018 the diagnosis of superior vena cava syndrome can be made with the typical findings above. Superior vena cava svc syndrome is the result of stenosis or occlusion of the svc or bilateral brachiocephalic veins. Superior vena cava obstruction radiology reference article. Superior vena cava svc syndrome results from any condition that. It transports blood from our arms, chest, neck, and head to our hearts.
The superior vena cava is located in the middle of the chest and is surrounded by rigid structures and lymph nodes. Although we initially considered this case to be a drug eruption because the patient had repeated episodes of worsening clinical presentation whenever he took. Treatment should also be individualized and should not be undertaken until a. Superior vena cava syndrome svcs refers to the clinical syndrome with symptoms that results from this obstruction. Nonmalignant superior vena cava syndrome in a patient. The symptoms that result from compression of the large vein that carries blood down to the heart.
Superior vena cava syndrome in thoracic malignancies philipp m lepper md, sebastian r ott md, hanno hoppe md, christian schumann md, uz stammberger md, antonio bugalho md, steffen frese md, michael schmu. In the preantibiotic era, the untreated infections were. Nonmalignant causes are increasing in prevalence due to expanding use of intravascular devices, which can result in thrombosis. Superior vena cava syndrome an overview sciencedirect. Superior vena cava syndrome svcs, is a group of symptoms caused by obstruction of the superior vena cava svc, a short, wide vessel carrying circulating blood into the heart. Cardiac 1 atrial myxomas 2 intrapericardial band 3 pericarditist. The presence of these collateral vessels is an important ancillary ct finding of superior vena cava syndrome, with a sensitivity of 96% and a specificity of 92% 4. The superior vena cava svc is a large valveless venous channel formed by the union of the brachiocephalic veins. Superior vena cava syndrome svcs is an acute or subacute oncologic emergency with typical clinical features. Malignancies are the main cause and are considered an oncologic emergency. Description superior vena cava syndrome is a partial occlusion of the. The photograph shows massive engorgement of collateral subcutaneous veins of the chest and abdomen in a 58yearold man with partial obstruction of the superior vena. Superior vena cava in a patient with superior vena cava syndrome. Marked facial and upper extremity swelling results in dysphagia, dyspnea, and pain.
Superior vena cava syndrome svcs develops when your superior vena cava is partially or fully blocked. A 42yearold male patient was seen at consultation presenting with a pulsatile, warm and slightly. Superior vena cava syndrome is diagnosed by ultrasound, chest xray, ct scan, and in some cases biopsy. Superior vena cava syndrome is a clinical diagnosis, and associated imaging findings include widening of the mediastinum on radiographs and mediastinal soft tissue on ct, interruption of contrast material within the superior vena cava on contrastenhanced ct, and opacification of collateral vascularity fig. The superior vena cava syndrome svcs is a rare pathological process caused by the superior vena cava obstruction. Congenital or acquired abnormalities can affect the diameter of svc. The etiologies and management of svcs have evolved over time. This condition is frequently due to a large anterior mediastinal mass compressing the svc. Superior vena cava syndrome svcs is a relatively common sequela of mediastinal malignancies and may cause significant patient distress. 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 upper extremities to the right atrium. Mar 17, 2015 superior vena cava syndrome svc syndrome slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Treatment should also be individualized and should not be undertaken until a diagnosis is obtained.
Superior vena cava syndrome presenting as position. The superior vena cava svc is the superior of the two venae cavae, the great venous trunks that return deoxygenated blood from the systemic circulation to the right atrium of the heart. The superior vena cava syndrome svcs is a rare pathological process caused by the superior vena cava obstruction svco. The resulting increased venous pressure in the upper body may cause edema of the head, neck, and upper. Malignant obstruction can be caused by direct invasion of tumor into the svc, or by external compression of the svc by an adjacent pathologic process involving the right lung, lymph nodes, and other mediastinal structures, leading to stagnation of flow and. We report a case of superior vena cava syndrome svcs caused by squamous cell lung carcinoma in a 49yearold man. Superior vena cava syndrome occurs when there is acute or subacute stenosis or occlusion of the superior vena cava. With the increasing use of intravascular devices, the incidence of the svc syndrome arising from benign etiologies is increasing. The syndrome is almost invariably secondary to a malignant process. Superior vena cava syndrome in thoracic malignancies. Causes of superior vena cava include lung cancer, lymphoma, other cancers in the chest, blood clots in the superior vena cava, or. 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.
Svcs is a medical emergency if associated with laryngeal or cerebral edema. Treatment depends on the etiology of the obstructive process. Superior vena cava syndrome is a set of signs and symptoms due to superior vena cava obstruction. Symptoms of the syndrome include shortness of breath. Infections such as tuberculosis, and extrinsic compression such as syphilitic aortic aneurysm, thymoma or thyroid goitre, are also known to cause superior vena cava syndrome. Superior vena cava syndrome an overview sciencedirect topics. As a consequence, various forms of therapy have been promptly. Superior vena cava svc obstruction can occur from extrinsic compression, intrinsic stenosis, or thrombosis. Appropriate imaging techniques are important to con.
Superior vena cava an overview sciencedirect topics. Superior vena cava syndrome svc syndrome slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Blood from your upper body normally flows through the superior vena cava and into the right side of your heart. Superior vena cava syndrome with malignant causes nejm. Superior vena cava syndrome symptoms, diagnosis and. Malignancies primarily lung cancer are the underlying cause of 8085% of cases, leaving 1520% caused by various benign conditions, including sclerosing. A 58yearold man presents with a 2week history of progressive dyspnea on exertion, neck swelling, decreased appetite, and fatigue. The majority of cases are caused by malignant tumors within the mediastinum, most commonly lung cancer and nonhodgkins lymphoma, directly compressing or invading. The diagnosis is supported by identifying a cause for the superior vena cava syndrome, typically requiring xray imaging or cat or mri scanning. He presented with severe edema of the face and upper half of the body with numerous dilated and tortuous cutaneous veins.
In superior vena cava syndrome svcs, this vein has. Svcs is a medical emergency if associated with laryngeal. Malignancyrelated superior vena cava syndrome uptodate. However, in last decades benign causes such as thrombosis related to venous access colocation have been described. 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. Characteristics of 20 patients suffering from superior vena cava syndrome related to malignant diseases who underwent a wallstent placement agegender cause of stenosis location of stenosis length of the stent superior vena cava syndrome relieved survival days number of procedures 1 49m pulm tum rul origin of brach cep 6 cm yes 30 2. Thrombectomy, thrombosis, superior vena cava syndrome, superior vena cava obstruction doi. Bilyeu, md approximately 15,000 cases of superior vena cava svc obstruction are diagnosed in the united states annually. 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.
Sep 01, 2017 the superior vena cava is one of the primary veins within our bodies. Review of evolving etiologies, implications and treatment. Superior vena cava syndrome svcs consists of the signs and symptoms of superior vena cava svc obstruction due to compression or thrombosis. Pdf on jun 1, 2012, khaldoon shaheen and others published superior vena cava syndrome find, read and cite all the research you need on researchgate.
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