Clarkepearson md, in clinical gynecologic oncology ninth edition, 2018. Vena kava is responsible for venous drainage of superior head, neck, arms and upper thorax and the heart performs a third of the venous conversion. 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. If the obstruction involves both brachiocephalic veins, it is recommended to place stents in. A cancerrelated medical emergency more pulmccm topic updates multiple cancers are expected to rise in prevalence in the u. 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 syndrome associated with righttoleft shunt through systemictopulmonary venous collaterals the harvard community has made this article openly available. The full text of this article is available in pdf format. Superior vena cava syndrome and superior mediastinal syndrome. Superior vena cava syndrome, topics in thoracic surgery, paulo f.
However, because the majority of cases are caused by cancer. Review of evolving etiologies, implications and treatment strategies. Vascular thrombosis, especially venous, is common in this condition and also constitutes a basic diagnostic criterion. Case presentation 58 yo female presented with cough productive of yellow sputum, sore throat and fever with chills for 1 week. Blood from your upper body normally flows through the superior vena cava and into the right side of your heart. Obstruction of the superior vena cava svc may occur as an acute or subacute process producing a syndrome with characteristic features including facial edema and plethora, dilation of chest wall and neck veins, mild to moderate respiratory difficulty, and, less commonly, conjunctival edema, central nervous system complaints such as headache, or, more rarely, visual disturbances. Superior vena cava syndrome is most often caused by compression of the vein the superior vena cava, that returns blood from the upper body back to the right atrium of the heart by tumor. She was asymptomatic until six months before admission when she developed pain and swelling in the face and both upper. Superior vena cava syndrome an overview sciencedirect topics. Svcs is a medical emergency if associated with laryngeal or cerebral edema. Superior vena cava syndrome svcs, is a group of symptoms caused by obstruction of the superior vena cava a short, wide vessel carrying circulating blood. Superior vena cava svc syndrome results from any condition that leads to obstruction of blood flow through the svc. Superior vena cava syndrome superior vena cava obstruction. Superior vena cava svc syndrome is a collection of clinical signs and symptoms resulting from either partial or complete obstruction of blood.
Thrombectomy, thrombosis, superior vena cava syndrome, superior vena cava obstruction doi. Superior vena cava svc syndrome has a characteristic and often striking clinical presentation, which can occa sionally be life threatening. Superior vena cava syndrome svcs is a medical emergency which consists of the obstruction of blood flow through the superior vena cava. Svc obstruction is a narrowing or blockage of the superior vena cava svc, which is the second largest vein in the human body. Superior vena cava syndrome an overview sciencedirect. Superior vena cava syndrome, phleboscanner, endoprosthesis, overload syndrome, central. Superior vena cava syndrome ranjita pallavi,md internal medicine pgy2 2.
Superior vena cava svc syndrome results from the obstruction of blood flow through the svc, having distinct pathophysiological underlying mechanisms. For a few, superior vena cava syndrome svc syndrome will be the. Oct 01, 2017 superior vena cava syndrome occurs when the superior vena cava becomes blocked. Superior vena cava syndrome svcs is obstruction of blood flow through the superior vena cava svc. If you continue browsing the site, you agree to the use of cookies on this website. For a few, superior vena cava syndrome svc syndrome will. Superior vena cava syndrome is a form of vessel obstruction that occurs as a result of mechanical compression or due to thrombosis. It is most often caused by cancer or a tumor in the mediastinum the area of the chest under the. Anatomy and physiology of superior vena cava syndrome. Review of evolving etiologies, implications and treatment.
Abstract neonatal inferior vena cava syndrome ivcs, though uncommon, is associated with significant morbidity and mortality. This condition is frequently due to a large anterior mediastinal mass compressing the svc. The etiologies and management of svcs have evolved over time. The resulting increased venous pressure in the upper body may cause edema of the head, neck, and upper. This is most commonly due to tumours that either compress the. Primary or metastatic cancer in the upper lobe of the right lung can compress the superior vena cava.
Superior vena cava svc syndrome is a clinical syndrome which is. Radioanatomy of the superior vena cava syndrome and therapeutic. Superior vena cava syndrome occurs when the superior vena cava becomes blocked. Superior vena cava syndrome svcs develops when your superior vena cava is partially or fully blocked. Mar 27, 2020 superior vena cava syndrome svcs is obstruction of blood flow through the superior vena cava svc. Mar 17, 2015 superior vena cava syndrome svc syndrome slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Symptoms include facial edema, dyspnea, cough, neck distension, hoarseness and dysphagia, while severe cases may present with coma and severe respiratory distress. Obtaining tissue diagnosis is important to confirm presence of malignancy.
However, in last decades benign causes such as thrombosis related to venous access colocation have been described. Superior vena cava syndrome in children springerlink. A 58yearold man presents with a 2week history of progressive dyspnea on exertion, neck swelling, decreased appetite, and fatigue. It is a medical emergency and most often manifests in patients with a malignant disease process within the thorax. 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. 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.
Superior vena cava syndrome etiology bmj best practice. Superior vena cava syndrome svcs is rare in childhood. Superior vena cava syndrome possibilities of intervention. Symptoms include swelling of the face and arms associated with shortness of breath. Congenital or acquired abnormalities can affect the diameter of svc. Epidemiology svcs develops in about 510% of patients with. 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.
Role of irradiation in the management of superior vena cava syndrome. Your story matters citation juan, yuhsiang, sachin s. Nonmalignant svcs is typically caused by infectious etiologies or by thrombus in the superior vena cava. Superior vena cava syndrome associated with righttoleft. Superior vena cava obstruction presenting with epistaxis, haemoptysis and gastrointestinal haemorrhage in two men receiving haemodialysis with central venous catheters. Bartram u, van praagh s, levine jc, hines m, bensky as, van praagh r. The superior vena cava is the large vein that carries blood from the head, neck, arms and chest to the heart. A 42yearold male patient was seen at consultation presenting with a pulsatile, warm and slightly. Superior vena cava syndrome svcs is a relatively common sequela of mediastinal malignancies and may cause significant patient distress. She was asymptomatic until six months before admission when she developed pain and swelling in the face and both upper extremities, at which time she was treated with chlorothiazide diuril. Description superior vena cava syndrome is a partial occlusion of the. An individualized clinical approach is important to pursue the accurate diagnosis of the.
Superior vena cava syndrome is caused by obstruction of the thoracic vascular bed by either external com pression or occlusion. Superior vena cava syndrome possibilities of intervention therapy beran s. Diagnosis could be confirmed in 17 cases as one child succumbed to. This is most commonly due to tumours that either compress the vessel from the outside, or invade the vessel itself. Superior vena cava syndrome discharge care what you. Malignancyrelated superior vena cava syndrome uptodate. 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.
Its affection of the superior vena cava is rather rare with only a few cases described in the literature. A reassessment of the clinical applications of the superior vena cava syndrome. Cancer is associated with an increased risk of thromboembolism that varies according to patient, tumor, and treatmentrelated factors. 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. Superior vena cava syndrome is referred to as a constellation of symptoms and signs caused by obstruction of superior vena cava. May 01, 2008 superior vena cava syndrome svcs is rare in childhood. Primary tumors are most commonly the cause of this syndrome. Anesthetic implications of superior vena cava syndrome in. Superior vena cava syndrome svcs is a collection of symptoms that usually occur in patients who have lung cancer, nonhodgkin lymphoma, or other cancers. Twenty one children 20 males and 1 female with a median age of 10.
Svcs is a significant disorder affecting up to 10 % of small cell lung cancer sclc patients and 24 % of all lung cancer patients. Superior vena cava syndrome in thoracic malignancies. Superior vena cava obstruction presenting with epistaxis, haemoptysis and gastro. This summary explains svcs and its treatment in adults and children. Abstract superior vena cava syndrome svcs results in vascular, respiratory, and neurologic compromise. A restriction of the blood flow occlusion through this vein can cause superior vena cava syndrome svcs. 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. Superior vena cava syndrome statpearls ncbi bookshelf.
Symptoms of the syndrome include shortness of breath. 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 svc syndrome is the result of stenosis or occlusion of the svc or bilateral brachiocephalic veins. A clot was surgically removed from the left subclavian vein. Superior vena cava syndrome svcs is a medical condition which consists of the obstruction of blood flow through the superior vena cava. 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. Superior vena cava syndrome svcs is a group of symptoms that occur when there is pressure on the superior vena cava, or it is partially blocked and blood cant flow back to the heart normally.
It can occur due to both benign and malignant causes with the. Malignancies primarily lung cancer are the underlying cause of 8085% of cases, leaving 1520% caused by various benign conditions, including sclerosing. Appropriate imaging techniques are important to confirm the diagnosis and rule out other causes of svc syndrome. Superior vena cava syndrome revealing a behcets disease. Lung cancer is the most common etiology, nonsmall cell lung cancer accounting for 50% of cases of malignant svc syndrome and small cell lung cancer for 25% cases. Francesco puma and jacopo vannucci february 15th 2012. The superior vena cava is one of the primary veins within our bodies. A 41yearold woman was admitted five years ago with pain and swelling in the left arm. Definition vena cavas superior syndrome vkss, right vena cava superior vks clinical findings due to obstruction in atrial discharge and the name given to the group of symptoms. Dialysis accessinduced superior vena cava syndrome. Superior vena cava syndrome discharge care what you need. Clinical condition that occurs due to obstruction of the superior vena cava. Superior vena cava syndrome itself is very treatable, and symptoms are usually greatly improved within the first month of treatment.
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 syndrome is diagnosed by ultrasound, chest xray, ct scan, and in some cases biopsy. The majority of cases are caused by malignant tumors within the mediastinum, most commonly lung cancer and nonhodgkins lymphoma, directly compressing or invading. Superior vena cava syndromea proposed classification system. Nonhodgkins lymphoma nhl is the most common cause of svcs in children. Superior vena cava syndrome investigations bmj best. Superior vena cava syndrome is a set of signs and symptoms due to superior vena cava obstruction. The syndrome was originally described as being secondary to an infection, such as tuberculosis, or a syphilitic aortic aneurysm 24. Superior vena cava syndrome investigations bmj best practice. Superior vena cava syndrome svc syndrome slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising.
Superior vena cava syndrome definition of superior vena. The superior vena cava moves blood from the upper half of the body to the heart. Superior vena cava svc syndrome occurs in approximately 15,000 people in the united states each year. Superior vena cava syndrome svcs consists of the signs and symptoms of superior vena cava svc obstruction due to compression or thrombosis. 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. Currently, svc syndrome is generally due to cancer or thrombotic events. Superior vena cava syndrome with malignant causes nejm. Superior vena cava syndrome canadian cancer society. In superior vena cava syndrome svcs, this vein has become obstructed or compressed to some degree. The most common cause of superior vena cava syndrome is cancer. The diagnosis can be made clinically, but imaging studies are recommended for confirmation.
Sep 01, 2017 superior vena cava syndrome itself is very treatable, and symptoms are usually greatly improved within the first month of treatment. 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 symptoms, diagnosis and. Bilyeu, md approximately 15,000 cases of superior vena cava svc obstruction are diagnosed in the united states annually. She was seen earlier in clinic with similar complaints and given a course of zithromax. Malignancies primarily lung cancer are the underlying cause of 8085% of cases, leaving 1520% caused by.
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