SVC Obstruction

Question 1

What type of presentation is SVC obstruction?

Answer 1

Oncological emergency

Question 2

Which cancer is SVC obstruction most commonly associated with?

Answer 2

Lung cancer

Question 3

List 6 causes of SVC obstruction

Answer 3

Common malignancies: SCLC, lymphoma
Other malignancies: metastatic seminoma, Kaposi’s sarcoma, breast cancer
Aortic aneurysm
Mediastinal fibrosis
Goitre
SVC thrombosis

Question 4

List 5 S/S of SVC obstruction

Answer 4

Dyspnoea (most common)
Swelling of face, neck + arms: conjunctival + periorbital oedema may be seen
Headache: often worse in mornings
Visual disturbance
Pulseless jugular venous distension

Question 5

What is often the treatment of choice to provide symptom relief in SVC obstruction?

Answer 5

Endovascular stenting

Question 6

Rather than stenting, what may patients with SVC obstruction due to SCLC or lymphoma benefit from>

Answer 6

Radical chemo or chemo-radiotherapy

Question 7

Despite the weak evidence base, what medication is often given in SVC obstruction?

Answer 7

Glucocorticoids