Localized idiopathic fibrosing mediastinitis as a cause of superior vena cava syndrome: a case report.

An unusual case of superior vena cava syndrome, caused by localized fibrosing mediastinitis is presented. A 41-year-old woman had swelling of the face and upper extremities, associated with headache and fatigue. Radiologic investigations, which included venography, computed tomography and magnetic resonance imaging of the chest, documented the presence of superior vena caval (SVC) obstruction secondary to what appeared to be an intraluminal tumour. The patient underwent SVC resection and reconstruction with a spiral saphenous vein graft under cardiopulmonary bypass and deep hypothermic circulatory arrest. On histopathological examination localized idiopathic fibrosing mediastinitis causing SVC obstruction was diagnosed.