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Superior Vena Cava Syndrome

Superior Vena Cava (SVC) is a major vessel (vein) in the chest that drains the blood from the upper part of the body into the heart. Occlusion of this vein can cause Superior Vena Cava Syndrome (SVCS).

This syndrome can happen in association with cancers that involve the upper part of the chest, including:

• Lung cancer

• Lymphomas

• Metastatic breast cancer to chest

• Metastatic cancer of testis

Alternatively, SVC obstruction may occur in patients with some non-cancerous illness --

• Blood clot formation in SVC

• Enlargement of thyroid gland in the chest

• Tuberculosis

• Sarcoidosis, etc.

Signs and symptoms:

Patients with Superior Vena Cava Syndrome may experience:

• Swelling of the face, tight shirt collar

• Swelling of the arms

• Distention and enlargement of the superficial veins

• Shortness of breath

• Change in the voice

• Cough

• Confusion

Diagnosis:

Superior Vena Cava Syndrome should be considered with any cancer patient who would present with the above signs, especially with swelling of the face and arms. The diagnosis can be confirmed by a plain chest x-ray, CT Scan or MRI of the chest.

The next step is to establish the cause of SVCS. This is a very simple task in patients who are known to have a cancer. However, some patients present with this syndrome and it is through the evaluation and work up of this problem that a cancer is diagnosed.

Treatment:

Treatment of Superior Vena Cava Syndrome relies on the cause of it. Radiation is used in the majority of cancer patients. Chemotherapy is the treatment of choice for cancers that are very sensitive to treatment, i.e., lymphoma, testis cancer, small cell lung cancer, etc.

Certain procedures can be used to dilate and open the occluded vessel. Such procedures may be performed by radiologists or vascular surgeons.

Prognosis:

The prognosis depends on the underlying cause of SVCS.