Superior Vena Cava Syndrome: An Uncommon Presentation of a Rare Colon Carcinoma Metastasis

Eur J Case Rep Intern Med. 2019 May 15;6(5):001115. doi: 10.12890/2019_001115. eCollection 2019.

Abstract

Introduction: Superior vena cava (SVC) syndrome is caused by obstruction of the superior vena cava due to vascular compression by a mass or intrinsic obstruction. The authors describe SVC syndrome caused by an isolated metastatic mediastinal mass from a resected primary colon carcinoma.

Case report: An 81-year-old woman was referred to the hospital with swelling of the neck and upper left limb, dysphonia and dysphagia, associated with an involuntary weight loss of 16 kg. Mediastinal metastasis of colon adenocarcinoma was found, causing the SVC syndrome. The mass was unresectable and the patient was referred to palliative radiotherapy.

Discussion: Only 12 cases of mediastinal metastasis from colorectal cancer have been reported in the English literature.

Conclusion: As a rare manifestation of colorectal cancer, the presented case highlights the need for clinicians to be aware of rare metastases at the time of diagnosis.

Learning points: Superior vena cava (SVC) syndrome can result from vascular compression by a mass.Although mediastinal lymph node metastasis is rare in colorectal cancer, physicians should be aware of less common locations.Patients should have a close follow-up in order to avoid the growth of unresectable metastases, since surgery, when possible, can lead to a better prognosis.

Keywords: Colon cancer; mediastinal mass; metastasis; subcutaneous nodules.