Superior vena cava syndrome as tumour presentation

Rev Port Pneumol. 2010 Jan-Feb;16(1):73-88.
[Article in English, Portuguese]

Abstract

Superior vena cava syndrome (SVCS) is characterised by gradual and insidious compression/obstruction of the superior vena cava (SVC). Upper chest and neck ingurgitation, plethoric face and oedema are the common symptoms/signs. It generally means the presence of neoplasm, namely lung cancer.

Aim: Retrospective analysis of the patients admitted to S. João Hospital, Porto, Portugal, January 1995-December 2006 with SVCS without previous diagnosis. Patients, tumour characteristics and prognostic factors were studied.

Material and methods: Data was collected by consulting the clinical files of 60 SVCS patients without previous diagnosis. Data was gathered on the patients' demographic characteristics (age, gender, smoking habits), performance status, histology, staging, treatment and overall survival.

Results: Lung cancer was observed in 87% of the patients. Small-cell lung cancer (SCLC) was the most frequent histological type; 41% of the patients. It is noticeable that 10% were diagnosed with non- Hodgkin's lymphoma. In terms of prognostic factors analysed, the absence of metastasis, the lymphoma's histological diagnosis, good performance status and non-smoker status were positively correlated with the survival rate. On the contrary SCLC was significantly correlated with a worse survival.

Conclusions: In our analysis we concluded that SCLC, smokers and a poorer performance status as well as metastatic disease were unfavourable prognostic factors to SVCS as tumour presentation.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Lung Neoplasms / complications*
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / mortality
  • Male
  • Middle Aged
  • Retrospective Studies
  • Superior Vena Cava Syndrome / etiology*
  • Superior Vena Cava Syndrome / mortality
  • Survival Rate
  • Young Adult