Syphilitic aortic aneurysm presenting with the superior vena cava syndrome

In a 65 year old man with hemoptysis, chest pain, weight loss, clubbing of the digits and a large mediastinal mass, the superior vena cava syndrome developed. He was treated for malignancy with radiation therapy and corticosteroids, but he died shortly after his admission to the hospital. Autopsy revealed syphilitic aortitis with an aneurysm of the ascending aorta compressing the superior vena cava and right mainstem bronchus. The postmortem serology corroborated the morphologic findings of tertiary syphilis. In this report we emphasize the important, although now uncommon, association between the superior vena cava syndrome and aneurysm of the aorta.