Pemberton's maneuver - a clinical test for latent superior vena cava syndrome caused by a substernal mass

A 62-year-old white male presented with facial erythema and jugular vein distension in upright position which progressed to cyanosis and facial edema while keeping both arms elevated (Pemberton sign). A CT scan revealed a large substernal goiter as the cause of superior vena cava syndrome. Symptoms and signs disappeared after thyroid surgery. First reported in 1946 Pemberton's maneuver is a useful but unrecognized clinical sign for oligosymptomatic superior vena cava syndrome caused by a substernal mass.