Superior vena caval obstruction from thrombus

Case contributed by Dr Lawrence Chia Wei Oh

Presentation

Neck pain with bilateral arm swelling

Patient Data

Age: 60
Gender: Male

This CT chest demonstrates extensive and occlusive thrombus in the superior vena cava. Superiorly it extends into the inferior aspect of right jugular vein and subclavian vein.

Associated significant mediastinal lymphadenopathy, pleural effusion and thickening of the left lung interstitial.

Case Discussion

This is a gentleman with a known history of metastatic oesophageal cancer and has been on long term therapeutic clexane for bilateral pulmonary embolism in the last few months. In this presentation, the patient's symptoms were highly suspicious for SVC obstruction. His SVC thrombosis could be due to hypercoagulable state secondary to underlying malignancy or possibly a clotting disorder. 

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Case information

rID: 23483
Case created: 18th Jun 2013
Last edited: 21st Feb 2017
System: Chest
Inclusion in quiz mode: Included

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