MyMedR

Superior vena cava obstruction bypass - an alternative technique using bovine pericardial conduit: a case report

Abdullah F, Adeeb S

Heart Surg Forum, 2003;6(3):E50-1.

An alternative technique of superior vena cava obstruction bypass using bovine pericardial conduit is described. The patient in this case had recurrent bilateral thrombophlebitis and thrombosed saphenous veins. Most of the surgical techniques reported in the literature so far have described the use of polyethylene terephthalate (Dacron) graft, polytetrafluoroethylene graft, autologous pericardial patch, and spiral vein graft. The use of synthetic grafts has been plagued with high rates of thrombosis. The pathology, clinical presentation, surgical technique, and outcome are discussed.

Matched MeSH terms: Superior Vena Cava Syndrome/drug therapy; Superior Vena Cava Syndrome/surgery*

Salvaging the chemoport using catheter-assisted deflection during stenting of the superior vena cava

H'ng MWC, Dennien B

Med J Malaysia, 2020 11;75(6):754-755.

PMID: 33219194

Patients with malignancy who develop superior vena cava (SVC) obstruction may require stenting to relieve their symptoms. Some of these individuals also have an indwelling chemoport for concomitant chemotherapy. We present a case where stenting was accomplished after catheter-assisted deflection of the chemoport catheter tubing via a single groin access. It can save procedure time whilst salvaging the device.

Matched MeSH terms: Superior Vena Cava Syndrome

Anesthetic management of a parturient with superior vena cava obstruction for cesarean section

Chan YK, Ng KP, Chiu CL, Rajan G, Tan KC, Lim YC

Anesthesiology, 2001 Jan;94(1):167-9.

PMID: 11135739

Matched MeSH terms: Superior Vena Cava Syndrome/etiology*

Simultaneous bypass grafting of the superior vena cava and intrathoracic biopsy in fulminant superior vena caval syndrome

Majid AA

J R Coll Surg Edinb, 1991 Dec;36(6):406-8.

PMID: 1774712

Matched MeSH terms: Superior Vena Cava Syndrome/surgery*

Superior vena caval syndrome secondary to metastatic renal cell carcinoma

Lim NK, Aik OT, Meng LL, Htun TH, Razack AH

J Coll Physicians Surg Pak, 2014 Mar;24 Suppl 1:S68-70.

PMID: 24718014 DOI: 03.2014/JCPSP.S68S70

Superior vena caval syndrome (SVCS) is a debilitating condition attributed to malignancy in more than 70% of cases. However, solitary head and neck metastases arising from renal cell carcinomas without evidence of disease elsewhere are rare. We report a case of renal cell carcinoma presenting as a rapidly growing right cervical lymph node with compression on the subclavian vein causing superior vena caval syndrome (SVCS). There was pulmonary embolism as well. Biopsy of the neck mass confirmed metastatic clear cell carcinoma with primary found in the (L) kidney. The patient had partial response to focussed radiotherapy to neck mass and Sunitinib (tyrosine kinase inhibitor) before succumbing to the disease.

Matched MeSH terms: Superior Vena Cava Syndrome/drug therapy; Superior Vena Cava Syndrome/etiology*

Malignant obstruction of superior vena cava: Endovascular stenting using Y-configuration stent in stent technique

Noor Khairiah AK, Mohamad Nazrulhisham MN, Hazman MN

Med J Malaysia, 2018 12;73(6):407-409.

PMID: 30647215

Malignant intrathoracic disease is the commonest cause of superior vena cava (SVC) obstruction. Life threatening SVC obstruction with intense dyspnoea requires urgent treatment. SVC stenting has been developed in recent years which results in rapid relief of the obstruction. The Yconfiguration technique has been reported to provide support for all three limbs of the bifurcation to prevent restenosis. At present, there are limited reports on the use of Y-configuration stent in stent techniques for endovascular stenting in malignant SVC obstruction. We share our clinical experience of two patients who received balloon-mounted stents using this technique.

Matched MeSH terms: Superior Vena Cava Syndrome/etiology; Superior Vena Cava Syndrome/surgery*

Fulltext Metastatic Adenocarcinoma Presenting as Extensive Cavoatrial Tumor Thrombus

Johari B, Abdul Aziz YF, Krishnasamy S, Looi LM, Hashim SA, Raja Mokhtar RA

Iran J Radiol, 2015 Apr;12(2):e11197.

PMID: 26060549 DOI: 10.5812/iranjradiol.11197

The presence of tumor thrombus in the right atrium is frequently the result of direct intraluminal extension of infra-diaphragmatic malignancy into the inferior vena cava (IVC) or supradiaphragmatic carcinoma into the superior vena cava (SVC). Right atrial tumor thrombus with extension into both SVC and IVC has not been reported in the literature. We present a patient who presented with symptoms of right atrial and SVC obstruction. Imaging revealed presence of a thrombus in the right atrium, extending to the SVC and IVC, with the additional findings of a left adrenal mass and multiple liver lesions. The histopathological examination of the right atrial mass revealed metastatic adenocarcinoma cells. The patient was given a presumptive diagnosis of metastatic adenocarcinoma, most likely adrenal in origin, with multiple hepatic lesions suspicious for metastasis. The clinical outcome of the patient was not favorable; the patient succumbed before the adrenal mass could be confirmed to be the primary tumor. This case highlights that in patients manifesting with extensive cavoatrial thrombus as, the existence of primary carcinoma should be considered especially in the adrenal cortex or in the lung.

Matched MeSH terms: Superior Vena Cava Syndrome

Fulltext Diagnostic challenge in diagnosing bilateral breast metastases from mediastinal neuroendocrine tumor: A case report

Chan KH, Lee CH, Sharif SZ, Hayati F, Sallapan S

Ann Med Surg (Lond), 2020 Dec;60:438-441.

PMID: 33251002 DOI: 10.1016/j.amsu.2020.11.035

Background: Metastatic neuroendocrine tumours (NETs) to the breast are very rare entities.

Case presentation: A 26-year-old lady presented with anterior neck swelling with symptoms of superior vena cava syndrome for 6 months. Imaging study revealed a mediastinal mass which was preceded with core biopsy which was consistent with high-grade small cell NETs. Despite second-line adjuvant chemotherapy and radiotherapy, her disease became advanced which was confirmed via restaging scan. There were bilateral breast lesions discovered during the scan which was deemed to be metastatic NETs histologically. Despite prompt initiation of treatment, she succumbed 1 year after the radiotherapy due to disease progression.

Conclusion: High suspicion of an index is needed for diagnosis when patients with known primary NETs present with suspicious breast lesions. Triple assessment is mandatory, however histopathology assessment and immunohistochemistry staining are the mainstay of diagnosis.

Matched MeSH terms: Superior Vena Cava Syndrome

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