Superior Vena Cava Obstruction (SVCO)
Malignant mediastinal lymphadenopathy can result in SVCO. The most common cause is lung cancers (causing 60-70% of malignant SVCOs) especially small cell lung cancer. Other causes of malignant SVCO include breast cancer, lymphoma and germ cell tumor.
Patients present with facial and neck swelling, dyspnea, headaches, chest wall distension and occasionally syncope. SVCO is a palliative care urgency and requires prompt attention.
Treatment depends on anticipated life expectancy:
Mr. Silver was treated with an accelerated course of radiation therapy and continued on the Decadron with significant improvement in his breathlessness.