Superior Vena Cava Obstruction

Question 1

True or false: Superior vena cava obstruction is an oncological emergency.

Answer 1

True.

Superior vena cava obstruction is an oncological emergency.

Question 2

What is the most common cause of superior vena cava obstruction?

Answer 2

Lung cancer

Question 3

What are the key features of superior vena cava obstruction?

Answer 3

Dyspnoea

Swelling of face, neck and arms. May feature conjunctival and periorbital oedema.

Headache (worse in AM)

Visual disturbance

Pulseless JVP distension

Question 4

What are the causes of superior vena cava obstruction?

Answer 4

Common malignancies: small cell lung cancer, lymphoma

Other malignancies: metastatic seminoma, Kaposi’s sarcoma, breast cancer

Aortic aneurysm

Mediastinal fibrosis

Goitre

SVC thrombosis

Question 5

How is superior vena cava obstruction managed?

Answer 5

Dexamethasone

Balloon venoplasty, stenting

Chemo and radiotherapy for small cell lung cancer

Radiotherapy alone for non-small cell lung cancer