[Superior vena cava syndrome: a study based on 81 cases]

Characterize the etiology, clinical picture, radiographic findings, usefulness of several diagnostic studies in establishing an etiologic diagnosis, and outcome after treatment of superior vena cava syndrome (SVCS).

We reviewed the charts of all patients diagnosed of SVCS in our hospital between the years 1983 and 1996.

Eighty-one patients (70 male, 11 female) with an average age of 61 years were included in the study. In 77 (95%) patients a neoplastic cause was diagnosed, mainly lung cancer (76%). The most common clinical findings were: feeling of fullness in the head (81%), edema of the face and arms (78%), jugular venous distention (75%), prominent venous pattern over the chest wall (73%), dyspnea (59%), and cough (37%). The average length of time from the onset of symptoms to the date of diagnosis was 28 days. The chest x-ray was abnormal in 78 (96%) cases: mediastinal widening (51%) and right hilar mass (48%) were the most common findings. The diagnosis of SVCS was evident (from clinical picture and chest roentgenogram) in 76 (94%) patients. In SVCS due to malignancy, the most productive investigations in establishing a pathologic diagnosis were bronchoscopy (54%) and biopsy of a superficial lymph node (18%). Partial or complete clinical response to treatment was achieved in seventy percent of the cases.

SVCS is an uncommon entity and his most frequent cause is bronchogenic carcinoma. The characteristic clinical and radiographic findings allow to do a reliable diagnosis of the syndrome. Initially, clinical response (partial or complete) to treatment is achieved in most patients.