Axillary vein thrombosis simulating superior vena cava syndrome

Area of Science:

• Vascular Surgery
• Diagnostic Imaging
• Oncology

Background:

• Superior vena cava (SVC) syndrome is a potentially life-threatening condition often requiring urgent treatment.
• Axillary vein thrombosis (AVT) can present with symptoms that overlap with SVC syndrome.
• Misdiagnosis can lead to inappropriate and potentially harmful treatment, such as radiotherapy.

Observation:

• Two cases are presented where axillary vein thrombosis was initially misdiagnosed as SVC syndrome.
• Patients were referred for immediate radiotherapy based on the initial incorrect diagnosis.
• Further patient history was critical in identifying the correct diagnosis.

Findings:

• Detailed patient history is essential to differentiate AVT from SVC syndrome.
• Abnormal chest x-ray findings may be incidental and unrelated to the presenting symptoms.
• Definitive diagnostic procedures, potentially including tissue diagnosis, are imperative before initiating therapy for suspected SVC syndrome.

Implications:

• Highlights the importance of comprehensive diagnostic evaluation in cases presenting with SVC syndrome symptoms.
• Emphasizes the need to consider alternative diagnoses like AVT, especially when initial findings are ambiguous.
• Underscores the potential risks of premature treatment based on incomplete diagnostic workups in vascular emergencies.