[Benign superior vena cava syndrome associated with Horner syndrome--report of a case]

Superior vena cava syndrome is commonly caused by malignant diseases such as lung cancer, malignant lymphoma and so forth. It is uncommon that benign diseases obstruct the superior vena cava or its major tributaries. But there are some documented cases of benign superior vena cava syndrome induced by mediastinitis, benign mediastinal tumors, and uncommon lesions having their primary origin in the mediastinum. A 41-year-old male patient had recognized his ptotic palpebra two years ago and chest roentgenographic examination disclosed a tumor shadow occupying the apex of the right thorax but he was almost asymptomatic except venous dilatation of the anterior chest wall. Venography revealed obstruction of the brachiocephalic vein and superior vena cava. At thoracotomy the tumor was found to be impacted at the apex of the thoracic fornix and to be cystic. Primary site of the tumor was at the chest wall and its histological finding was compatible with that of neurilemmoma. Postoperative venography confirmed complete patency of the brachiocephalic vein and superior vena cava.