Obstructive superior vena cava tumor thrombus

Case contributed by Henry Knipe


Metastatic NSCLC ?progress.

Patient Data

Age: 55
Gender: Male

Large right upper lobe mass abuts the right brachiocephalic vein and SVC. The SVC has a filling defect within it that appears to extend inferiorly to the cavo-atrial junction. Collateral venous drainage via the azygos system and IVC is noted.

Bony destruction of the posterior third and fourth ribs as well as right T3-T5 vertebral body, pedicle and transverse process. It is likely that tumor infiltrates the spinal canal at this level. Again, this appears stable. Old healing right sixth rib fracture.

The mass also abuts the trachea, encasing and compressing the right upper bronchus. It abuts the bronchus intermedius but without significant compression. Small bilateral pleural effusions with dependent atelectasis on the left.

Case Discussion

This case demonstrates an aggressive NSCLC with obstructive tumor thrombus in the SVC and destruction and invasion of the upper vertebral column. 

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