Difficulties in the management of superior vena caval obstruction in young adults

Case records of 50 patients of superior vena caval obstruction in young adults treated and followed-up at Radiotherapy Department, Medical College Hospitals, Calcutta have been looked into. Twenty-eight out of these 50 patients had disease confined to mediastinum only during presentation. In consideration of the fact that the optimum management of superior vena caval obstruction depends upon a balance between just adequate pretreatment investigation and early institution of treatment, the various difficulties in the management discussed. With the existing infrastructural facilities, the institutional policy for the management of superior vena caval obstruction in young adults whose disease is confined to mediastinum only, during presentation, is described.