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Malignant superior vena cava syndrome presenting after trauma

Published online by Cambridge University Press:  21 May 2015

Laura A. Price
Affiliation:
Resident, Royal College Emergency Medicine Program, University of Western Ontario London Health Sciences Centre, London, Ont.
Trevor L. Gilkinson*
Affiliation:
London Health Sciences Centre, London, Ont.
*
Department of Emergency Medicine, London Health Sciences Centre, 375 South St., London ON N6A 4G5; [email protected]; [email protected]

Summary:

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A 41-year-old man was brought to the ED after a motor vehicle crash. On presentation, he demonstrated symptoms compatible with superior vena cava (SVC) syndrome, including extreme dyspnea, face and neck cyanosis and facial swelling. A chest tube was inserted and drained large amounts of sanguineous fluid. An exploratory thoracotomy revealed an extensive tumour encasing the SVC and the hilum. Biopsy confirmed the diagnosis of T-cell lymphoma.

The most common cause of SVC syndrome is malignant disease, with bronchogenic carcinoma and lymphoma being most frequent. Review of the literature uncovered only a few anecdotal reports of traumatic SVC syndrome. There are no previous reported cases of malignant SVC syndrome presenting in association with trauma.

Type
Case Reports • Observations
Copyright
Copyright © Canadian Association of Emergency Physicians 1999

References

1.Varricchio, C.Clinical management of superior vena cava syndrome. Heart Lung 1985;14:4116.Google Scholar
2.Yellin, A, Rosen, A, Reichert, N, Lieberman, Y.Superior vena cava syndrome: the myth, the facts. Am Rev Respir Dis 1990;141: 11148.CrossRefGoogle ScholarPubMed
3.Parish, JM, Marschke, RF, Dines, DE, Lee, RE.Etiologic considerations in superior vena cava syndrome. Mayo Clin Proc 1981;56: 40713.Google Scholar
4.Schraufnagel, DE, Hill, R, Leech, JA, Pare, JA.Superior vena caval obstruction: Is it a medical emergency? Am J Med 1981;70: 116974.CrossRefGoogle ScholarPubMed
5.Armstrong, BA, Perez, CA, Simpson, JR, Hederman, MA.Role of irradiation in the management of superior vena cava syndrome. Int J Radiat Oncol Biol Phys 1987;13:5319.CrossRefGoogle ScholarPubMed
6.Little, AG, Golomb, HM, Ferguson, MK, Skosey, C, Skinner, DB.Malignant superior vena cava obstruction reconsidered: the role of diagnostic surgical intervention. Ann Thorac Surg 1985;40: 2858.CrossRefGoogle ScholarPubMed
7.Sculier, JP, Feld, R.Superior vena cava obstruction syndrome: recommendations for management. Cancer Treat Rev 1985;12: 20918.CrossRefGoogle ScholarPubMed
8.Razzouk, A, Gundry, S, Wang, N, Heyner, R, Sciolaro, C, Van Arsdell, G, et al. Pseudoaneurysms of the aorta after cardiac surgery or chest trauma. Am Surg 1993;59:81823.Google Scholar
9.Buechner, HA.Superior vena cava syndrome due to trauma to the posterior thorax. Am Rev Respir Dis 1979;120:7056.Google Scholar
10.Matthews, JI.Superior vena cava syndrome. Am Rev Respir Dis 1979;119:6834.Google ScholarPubMed