Superior Vena cava obstruction

Question 1

What is superior vena cava obstruction? Associated with?

Answer 1

Oncological emergency caused by compression of the SVC most commonly associated with lung cancer

Question 2

What are the causes of SVCO?

Answer 2

• common malignancies: small cell lung cancer, lymphoma
• other malignancies: metastatic seminoma, Kaposi’s sarcoma, breast cancer
• aortic aneurysm
• mediastinal fibrosis
• goitre
• SVC thrombosis

Question 3

What are the features of SVCO?

Answer 3

• dyspnoea is the most common symptom
• swelling of the face, neck and arms - conjunctival and *periorbital oedema may be seen
• headache: often worse in the mornings
• visual disturbance
• pulseless jugular venous distension

Question 4

What is the management of SVCO?

Answer 4

• general: dexamethasone, balloon venoplasty, stenting
• small cell: chemotherapy + radiotherapy
• non-small cell: radiotherap