Clinical radiological and etiological profile of patient with superior vena cava syndrome in Indian scenario

Abstract

Background: Superior vena cava syndrome (SVCS) may occur with an acute or sub acute onset producing a syndrome with characteristic feature including facial edema, plethora, dilatation of vein of chest wall and neck, mild to moderate respiratory difficulty and less commonly headache or more rarely visual disturbance and altered state of consciousness. Literature on different aspect of SVCS from India are lacking. So a study was undertaken at Institute of Respiratory Disease, Jaipur.Objective: To study clinic-etiological profile of patients with SVC obstruction, etiological distribution of SVCS and to assess the impact of etiological treatment on resolution of SVC obstruction and the symptoms related to it.Methodology: A prospective type of clinical study was conducted with 26patient. A detailed clinical history with presenting symptom, sign andradiographic presentation were noted.Results: Non small cell carcinoma (46.15%) was most common etiologyfollowed by small cell carcinoma (42.30%), lymphomas (7.58%) and fibrosing mediastanitis (3.84%).Commonest radiological presentation was right upper lobe lung mass in 46.15% cases. Bronchoscopy was most productive investigation in establishing the tissue diagnosis.Conclusion: Etiology of SVCS is static since last three decades. None of solo diagnostic tool is helpful in all cases. However bronchoscopy and relatively safer procedure like FNAC are helpful in quicker diagnosis. These are safer, cheaper and easier alternative to thoracotomy. Furthermore doppler imaging also help in detection of vascular complication like thrombus in great vein, that may be important factor in patient with Intractable SVCS.