ABSTRACT
Superior vena cava syndrome (SVCS) results from the impairment of blood flow through the superior vena cava into the right atrium. As most SVCSs are due to cancer and treatment will depend on tumor histology, clinical recommendations highlight the need of histologic diagnosis before any specific treatment is started. Although prompt clinical attention is important, SVCS is rarely a clinical emergency as it usually develops as a subacute process with no sudden development of severe clinical manifestations, giving time to clinical, radiological, and histological diagnosis.For instance, it can be some dissociation between severe radiologic appearance and mild-to-moderate clinical manifestations. Response rates to chemotherapy in sensitive tumors approach 80%, and it is the treatment of choice in SVCS caused by SCLC, lymphoma, and germ-cell tumors. The proportion that relapses following stent placement approaches 10%, frequently due to thrombus within the stent, but this percentage depends of the length of follow-up: with longer follow-up, even a 40% of re-stenosis is described.
