Superior vena cava syndrome as a paraneoplastic manifestation of soft tissue sarcoma (original) (raw)

Superior Vena Cava Syndrome Due to Thrombosis: A Case Report

Cureus

Superior vena cava (SVC) syndrome is a clinical entity with signs and symptoms resulting from obstruction of blood flow through the SVC. The resulting obstruction leads to edema in the upper body, including the head, neck, and upper extremities. Clinical signs and symptoms can include plethora, cyanosis, dyspnea, stridor, cough, and hoarseness, as well as more serious complications such as cerebral edema leading to headache, confusion, and coma. Here, we present an interesting case of a 66-year-old female, with a medical history of esophageal cancer in remission and thyroid cancer currently undergoing radiation therapy, who was admitted for facial and upper extremity swelling. The initial impression was of angioedema or an allergic reaction. Imaging studies showed thrombus in the SVC resulting in SVC syndrome. The patient was treated with heparin initially, with a plan for an interventional radiologist to perform catheter-guided thrombolysis. However, the patient became unstable and ended up requiring mechanical ventilation. The patient was eventually discharged on oral anticoagulants. This case was rare as the patient developed SVC syndrome from venous thrombosis in the absence of any external tumor compression or as a result of an intravascular catheter.

The superior vena cava syndrome caused by malignant disease

European Journal of Radiology, 2006

Objective: The superior vena cava (SVC) obstruction by malignant diseases is either by direct invasion and compression or by tumour thrombus of the SVC. Whatever is its cause, obstruction of the SVC causes elevated pressure in the veins draining into the SVC and increased or reversed blood flow through collateral vessels. Severity of the syndrome depends on the collateral vascular system development. Therefore, imaging of the collateral veins with variable location and connection is important in determining the extension and management of the disease. Our aims are to describe collateral vessels of the superior vena cava syndrome (SVCS) related with the malignant diseases and to assess the ability of multi-detector row CT with multiplanar and 3D volume rendering techniques in determining and describing collateral circulations. Materials and methods: We present CT angiography findings of seven patients with small cell carcinoma of the lung (n = 2), squamous cell carcinoma of the lung (n = 3), Hodgkin disease of the thorax (n = 1), and squamous cell carcinoma of the oesophagus (n = 1). The patients received contrast-enhanced CT scans of the chest and abdomen on a multi-detector row CT during breath holding at suspended inspiration. Results: CT images revealed the cause and level of the SVC obstruction in all patients with axial and multiplanar reconstructed images. The SVC showed total obstruction in five patients and partial obstruction in two patients. The most common experienced collateral vessels were azygos vein (6), intercostal veins (6), mediastinal veins (6), paravertebral veins (5), hemiazygos vein (5), thoracoepigastric vein (5), internal mammary vein (5), thoracoacromioclavicular venous plexus (5), and anterior chest wall veins (5). While one case showed the portal-systemic shunt, V. cordis media and sinus coronarius with phrenic veins were enlarged in two cases, and the left adrenal vein was enlarged in a patient. In one case, the azygos vein with reversed blood flow was drained into both inferior vena cava and hemiazygos vein with the left renal vein. Conclusion: Multi-detector row CT with multiplanar and 3D imaging is an effective tool in evaluation of the SVCS and has a greater advantage than the other imaging techniques. 3D volume rendering is a useful technique in determining and describing collateral circulations in addition to the primary disease process.

Tumoral Superior Vena Cava Syndrome: About 19 Cases

SAS Journal of Medicine

Introduction: Superior vena cava syndrome (SCS) results from obstruction of the superior vena cava and/or its brachiocephalic collaterals by extrinsic compression and/or by tumor or cruoric thrombosis. The aim of this work is to draw up the clinical, radiological and therapeutic profile of SCV linked to cancers whatever their histological types. Materials and methods: This is a retrospective study carried out at the Military Hospital Mohamed V -Rabat-, over a period of seven years, from January 1, 2011 to December 31, 2017. We included all the patients with histologically confirmed cancers, complicated by SCS. Results: 16 men and 3 women with cancer presented with SCS during the study period. Their average age was 53 years old. The SCS was indicative of neoplastic pathology in 63% of cases. The most common etiology was lung cancer (58%). The majority of patients received symptomatic treatment (oxygen therapy and corticosteroid therapy). Anticoagulant treatment at curative doses was ...

Thrombosis of the inferior vena cava and malignant disease

Thrombosis Research, 2014

Background: Inferior vena cava thrombosis (IVCT) is a rare event, and studies detailing its underlying aetiologies are scarce. Methods: One hundred and forty-one IVCT patients (57% females, median age 47 years) were analysed with a focus on malignancy-related thrombosis and compared with 141 age-and sex-matched control patients with isolated lower-extremity deep vein thrombosis. Results: Malignancies were more prevalent among IVCT patients compared with the control group (39% vs. 7.8%; P b 0.001). Malignancy-related IVCT more frequently involved the suprarenal and hepatic segments of the IVC and extended more often to the right atrium than IVCT did in non-cancer patients. Among IVCT patients with malignancies, renal cell carcinoma (38%) and other malignancies of the genitourinary tract (25%) were the most common tumours. Analysis of the underlying pathological mechanisms of malignancy-related thrombosis identified external compression of the IVC by tumour masses in 9 cases (16%), and progression of malignancy into the IVC (so-called "tumour thrombosis") in 24 cases (44%). The remaining 22 cases (40%) were attributed to malignancy-related hypercoagulability and the presence of additional venous thromboembolism risk factors, such as previous surgery, immobilisation, or chemotherapy. Conclusions: Malignancies substantially contribute to the risk of thrombosis involving the IVC. Tumour invasion, especially in cases of renal cell cancer and malignancy-related hypercoagulability are major triggering factors for thrombogenesis.

Superior vena cava syndrome: A medical emergency?

International Journal of Angiology, 2008

Superior vena cava (SVC) syndrome was originally described as being secondary to an infection. Currently, it is almost exclusively secondary to malignancy. A case of SVC syndrome presenting with dyspnea, facial swelling, neck distension and cough developed over a period of 10 days is reported. The approach included imaging studies and tissue diagnosis. Computed tomography scan of the chest revealed a lobulated mass on the right upper chest invading the mediastinum, and cytology obtained from bronchoscopy revealed squamous cell carcinoma. The etiology, diagnosis and treatment modalities of the SVC syndrome are discussed.

Inferior Vena Cava Syndrome: A Rare Complication

European Journal of Case Reports in Internal Medicine, 2020

Inferior vena cava syndrome is rare and often difficult to diagnose because of its rarity and consequent low suspicion. We describe the case of a 28-year-old female patient with a history of nephroblastoma of the right kidney, stage IV, with a favourable histology with epidural metastasis (D5–D9), diagnosed at 3 years of age. The patient underwent treatment with surgery, chemotherapy and radiotherapy. The patient suffered from sudden low back pain worsening over 2 weeks, with progressive inability to walk. The pain radiated to the front of the thighs. Concomitantly, oedema of the lower limbs with cephalocaudal progression was observed. At admission to our institution, the physical examination showed peripheral oedema, abdominal wall venous collaterals, an inability to walk due to low back pain in the supine position, with no neurological deficits. Lumbar MRI showed exuberant epidural venous congestion. The hypothesis of inferior vena cava thrombosis (IVCT) was considered and confirm...