BACKGROUND: Characterize the etiology, clinical picture, radiographic findings, usefulness of several diagnostic studies in establishing an etiologic diagnosis, and outcome after treatment of superior vena cava syndrome (SVCS). METHODS: We reviewed the charts of all patients diagnosed of SVCS in our hospital between the years 1983 and 1996. RESULTS: Eighty-one patients (70 male, 11 female) with an average age of 61 years were included in the study. In 77 (95%) patients a neoplastic cause was diagnosed, mainly lung cancer (76%). The most common clinical findings were: feeling of fullness in the head (81%), edema of the face and arms (78%), jugular venous distention (75%), prominent venous pattern over the chest wall (73%), dyspnea (59%), and cough (37%). The average length of time from the onset of symptoms to the date of diagnosis was 28 days. The chest x-ray was abnormal in 78 (96%) cases: mediastinal widening (51%) and right hilar mass (48%) were the most common findings. The diagnosis of SVCS was evident (from clinical picture and chest roentgenogram) in 76 (94%) patients. In SVCS due to malignancy, the most productive investigations in establishing a pathologic diagnosis were bronchoscopy (54%) and biopsy of a superficial lymph node (18%). Partial or complete clinical response to treatment was achieved in seventy percent of the cases. CONCLUSIONS: SVCS is an uncommon entity and his most frequent cause is bronchogenic carcinoma. The characteristic clinical and radiographic findings allow to do a reliable diagnosis of the syndrome. Initially, clinical response (partial or complete) to treatment is achieved in most patients.
BACKGROUND: Characterize the etiology, clinical picture, radiographic findings, usefulness of several diagnostic studies in establishing an etiologic diagnosis, and outcome after treatment of superior vena cava syndrome (SVCS). METHODS: We reviewed the charts of all patients diagnosed of SVCS in our hospital between the years 1983 and 1996. RESULTS: Eighty-one patients (70 male, 11 female) with an average age of 61 years were included in the study. In 77 (95%) patients a neoplastic cause was diagnosed, mainly lung cancer (76%). The most common clinical findings were: feeling of fullness in the head (81%), edema of the face and arms (78%), jugular venous distention (75%), prominent venous pattern over the chest wall (73%), dyspnea (59%), and cough (37%). The average length of time from the onset of symptoms to the date of diagnosis was 28 days. The chest x-ray was abnormal in 78 (96%) cases: mediastinal widening (51%) and right hilar mass (48%) were the most common findings. The diagnosis of SVCS was evident (from clinical picture and chest roentgenogram) in 76 (94%) patients. In SVCS due to malignancy, the most productive investigations in establishing a pathologic diagnosis were bronchoscopy (54%) and biopsy of a superficial lymph node (18%). Partial or complete clinical response to treatment was achieved in seventy percent of the cases. CONCLUSIONS: SVCS is an uncommon entity and his most frequent cause is bronchogenic carcinoma. The characteristic clinical and radiographic findings allow to do a reliable diagnosis of the syndrome. Initially, clinical response (partial or complete) to treatment is achieved in most patients.