Superior vena caval syndrome secondary to metastatic renal cell carcinoma

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.