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International Manual of Oncology Practice pp 973–989Cite as

Superior Vena Cava Syndrome

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Abstract

The superior vena cava syndrome (SVCS) involves a group of symptoms deriving from obstruction or compression of the superior vena cava. Malignant causes represents the majority of all cases of SVCS. Iatrogenic causes may be responsible for SVCS, considering the presence of intravascular devices. Infectious causes such as syphilis and tuberculosis have also been known to cause SVCS.

Conserning the clinical presentation of SVCS may be subacute or acute. The most typical presenting symptoms and signs are dyspnea, facial edema, jugular venous distention, upper body plethora, cough, orthopnea, stridor, chest pain, cyanosis, positive Pemberton’s sign, dysphagia, visual impairment, lethargy, and headache.

Diagnosis is obtained by the aid of chest X-ray, CT and MRI scans, venography, and nuclear flow studies. In addition to these, invasive methods, such as bronchoscopy, percutaneous needle biopsy, mediastinoscopy, and thoracotomy, can also be applied.

Several methods of treatment are available. Endovascular stenting by an interventional radiologist may provide potential relief of symptoms, in an acute setting with severe symptoms. In the case of SVCS deriving from non-small cell lung cancer and other metastatic solid tumors, radiotherapy is the main treatment. Chemotherapy is effective in small cell carcinoma of the lung, lymphoma, and germ cell tumor. Surgery is helpful for patients in whom a benign process is the cause. Glucocorticoids have an ambiguous effect, as they may be useful at lymphomas but with no benefit on lung cancer. Diuretics with a low-salt diet and head elevation may also be beneficial.

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Author information

Authors and Affiliations

  1. Department of Radiotherapy, University of Thessaly, School of Health Sciences, Faculty of Medicine, Biopolis, Larissa, Greece

    Maria Tolia & George Kyrgias

  2. Oncology Clinic, 401 General Military Hospital, Athens, Greece

    Nikolaos Tsoukalas

  3. Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece

    Ioannis Zerdes

  4. Department of Otolaryngology, University of Thessaly, School of Health Sciences, Faculty of Medicine, Biopolis, Larissa, Greece

    Jiannis Hajiioannou

Authors
  1. Maria Tolia
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  2. Nikolaos Tsoukalas
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  3. Ioannis Zerdes
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  4. Jiannis Hajiioannou
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  5. George Kyrgias
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Corresponding author

Correspondence to Maria Tolia .

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Editors and Affiliations

  1. Division of Medical Oncology, Federal University of São Paulo (UNIFESP) & Hospital Israelita Albert Einstein, São Paulo, Brazil, Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal

    Ramon Andrade De Mello

  2. Oncology Department, Henry Dunant Hospital Center, Athens, Greece

    Giannis Mountzios

  3. Department of Biomedical Sciences and Medicine, Universidade do Algarve, Faro, Portugal

    Álvaro A. Tavares

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Tolia, M., Tsoukalas, N., Zerdes, I., Hajiioannou, J., Kyrgias, G. (2019). Superior Vena Cava Syndrome. In: De Mello, R., Mountzios, G., Tavares, Á. (eds) International Manual of Oncology Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-16245-0_44

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