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[Idiopathic mediastinal fibrosis associated with hypercoagulability: a case report]
A Bauzá Alonso1, J P García Gómez, C Abades Vázquez
1Departamento de Medicina Interna, Clínica Universitaria de Navarra, Facultad de Medicina, Universidad de Navarra. anabauza@unav.es
Anales De Medicina Interna (Madrid, Spain : 1984)
|February 21, 2002
Summary
Mediastinal fibrosis, a rare condition, can cause superior vena cava obstruction. This case highlights an unusual obstruction due to thrombosis, successfully treated with anticoagulation, corticosteroids, and tamoxifen.
Area of Science:
- Cardiology
- Thoracic Surgery
- Oncology
Background:
- Mediastinal fibrosis is a rare condition involving fibrotic mass in the anterior mediastinum.
- It can invade adjacent structures like the esophagus, trachea, and superior vena cava.
- Superior vena cava obstruction occurs in only 1-2% of cases, typically due to extrinsic compression.
Observation:
- A rare case of mediastinal fibrosis associated with a hypercoagulability disorder was observed.
- The superior vena cava obstruction in this patient was caused by an intrinsic mechanism: thrombosis.
- This contrasts with the usual extrinsic compression by the fibrotic mass.
Findings:
- The patient presented with mediastinal fibrosis and superior vena cava obstruction due to thrombosis.
- Treatment involved a combination of oral anticoagulation, corticosteroids, and tamoxifen.
- The patient showed satisfactory evolution following this therapeutic approach.
Implications:
- This case expands the understanding of superior vena cava obstruction mechanisms in mediastinal fibrosis.
- It suggests that hypercoagulability disorders should be considered in such cases.
- The successful treatment outcome indicates potential therapeutic strategies for this rare presentation.
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