Presentation
65 years old female patient with history of mastectomy 10 years ago, newly diagnosed cancer colon on chemotherapy. Newly noticed facial and upper limbs edema, more on the left side.
Patient Data
A porta catheter is noted.
Superior vena cava is seen filled with an internal thrombus extending for an about 8.2 cm seen surrounding the porta catheter tube, continuing superiorly into the left brachiocephalic vein for about 3.6 cm segment and into the proximal part of the right brachiocephalic vein. The thrombus is reaching inferiorly ending at the cavo-atrial junction. Collateral venous channels are seen along the anterior chest wall.
Mild left pleural effusion. Patent pulmonary artery and its main branches down to the 3rd order branches with no filling defects or aneurysm formation.
Upper abdominal cuts showed few hepatic focal lesions (metastases).
Case Discussion
Superior vena cava thrombosis with brachiocephalic vein extensions and anterior chest wall venous collaterals.