Malignant Superior Vena Cava Syndrome: State of the Art
Vasileios Patriarcheas, Μaria Grammoustianou, Nikolaos Ptohis, Ioanna Thanou, Minas Kostis, Ioannis Gkiozos, Andriani Charpidou, Ioannis P. Trontzas, Nikolaos Syrigos, Ηλίας Κοττέας, Evangelos Dimakakos
Abstract
Superior vena cava syndrome (SVCS) is a clinical entity characterized by signs and symptoms arising from the obstruction or occlusion of the thin-walled superior vena cava (SVC) and can result in significant morbidity and mortality. Despite the rise of benign cases of SVCS, as a thrombotic complication of intravascular devices, it is most commonly seen secondary to malignancy as a consequence of thrombosis, direct invasion of tumor cells inside the vessel, or external compression. SVCS can be the initial presentation of a previously undiagnosed tumor in up to 60% of cases. Lung cancer and non-Hodgkin lymphoma (NHL) are responsible for up to 85%-90% of malignancy-related SVCS, while metastatic cancers account for approximately 10%. Herein, we review the pathophysiology, etiology, clinical presentation, diagnosis, and management of malignancy-related SVCS.