Emergency Department Diagnosis and Management of Superior Vena Cava Syndrome Secondary to Hodgkin’s Lymphoma: Case Report and Limited Literature Review of Emergency Department Management

Authors

  • Paul R. Henning FAAP, FACEP Department of Emergency Medicine, University of South Alabama, 307 N University Blvd, Mobile, AL 36688, USA
  • Larry B. Mellick FAAP, FACEP Department of Emergency Medicine, University of South Alabama, 307 N University Blvd, Mobile, AL 36688, USA

DOI:

https://doi.org/10.17140/EMOJ-9-171

Keywords:

Superior vena cava syndrome, Superior vena cava obstruction, Jugular venous distention, Hodgkin’s disease

Abstract

Superior vena cava (SVC) syndrome refers to the obstruction of blood through the SVC with limited case reports and literature reviews of its presentation and management. Here we discuss a 26-year-old male who presented with progressive chest pain and shortness of breath for 5-weeks. The exam showed facial and neck plethora and distension of the veins in the neck and chest wall. This case discusses SVC syndrome due to external compression by Hodgkin’s Lymphoma. The diagnostic approach and the clinical management of superior vena syndrome are reviewed.

References

Nguyen AL, Belderbos H, van Harten JG. Superior vena cava syndrome presenting as position-dependent periorbital edema. BMJ Case Rep. 2018; 2018: bcr2018225220. doi: 10.1136/bcr-2018-

Lianos GD, Hasemaki N, Tzima E, et al. Superior vena cava syn-Case Report | Volume 9 | Number 2 | Henning PR, et al drome due to central port catheter thrombosis: A real life-threat-ening condition. G Chir. 2018; 39(2): 101-106.

Kalinin RE, Suchkov IA, Shitov II, Mzhavanadze ND, Povarov VO. [Venous thromboembolic complications in patients with car-diovascular implantable electronic devices]. Angiol Sosud Khir. 2017; 23(4): 69-74.

Labriola L, Seront B, Crott R, Borceux P, Hammer F, Jadoul M. Superior vena cava stenosis in haemodialysis patients with a tunnelled cuffed catheter: prevalence and risk factors. Nephrol Dial Transplant. 2018; 33(12): 2227-2233. doi: 10.1093/ndt/gfy150

Zimmerman S, Davis M. Rapid fire: Superior vena cava syn-drome. Emerg Med Clin North Am. 2018; 36(3): 577-584. doi: 10.1016/j.emc.2018.04.011

Friedman T, Quencer KB, Kishore SA, Winokur RS, Madoff DC. Malignant venous obstruction: Superior vena cava syndrome and beyond. Semin Intervent Radiol. 2017; 34(4): 398-408. doi: 10.1055/s-0037-1608863

McCurdy M, Shanholtz CB. Oncological emergencies.Crit Care Med. 2012; 40(7): 2212-2222. doi: 10.1097/CCM.0b013e31824e1865

Anders H, Keller C. Pemberton’s maneuver - a clinical test for latent superior vena cava syndrome caused by a substernal mass. Eur J Med Res. 1997; 2: 488-490.

Tonkin R, Sladden C. What lies downstream? A case of superior vena cava syndrome presenting in the dermatology clinic: A case report. SAGE Open Med Case Rep. 2020; 8: 2050313X20919618. doi: 10.1177/2050313X20919618

De Potter B, Huyskens J, Hiddinga B, et al. Imaging of urgen-cies and emergencies in the lung cancer patient. Insights Imaging. 2018; 9(4): 463-476. doi: 10.1007/s13244-018-0605-6

Markman M. Diagnosis and management of superior vena cava syndrome. Cleve Clin J Med. 1999; 66(1): 59-61. doi: 10.3949/ ccjm.66.1.59

Yu B, Wilson L, Detterbeck F. Superior vena cava syn-drome – a proposed classification system and algorithm for management. J Thorac Oncol. 2008; 3(8): 811-814. doi: 10.1097/ JTO.0b013e3181804791

Kaustav T, Soumandip P, Sandep G, Kallol B, Rajesh M. Superi-or vena cava syndrome: A radiation oncologist’s perspective. J Can-cer Res Ther. 2016; 12(2): 515-519. doi: 10.4103/0973-1482.177503

Rowell NP, Gleeson FV. Steroids, radiotherapy, chemotherapy and stents for superior vena caval obstruction in carcinoma of the bronchus. Cochrane Database Syst Rev. 2001; (4): CD001316. doi: 10.1002/14651858.CD001316

Ostler PJ, Clark DP, Watkinson AF, Gaze MN. Superior vena cava obstruction: A modern management strategy. Clin Oncol (R Coll Radiol). 1997; 9(2): 83-89. doi: 10.1016/s0936-6555(05)80445-5

Marcy P, Magne N, Bentolli F, Drouillard J, Bruneton J, Des-camps B. Superior vena cava obstruction: Is stenting necessary? Support Care Cancer. 2001; 9: 103-107. doi: 10.1007/s005200000173

Lanciego C, Pangua C, Chacón JI, et al. Endovascular stenting as the first step in the overall management of malignant superior vena cava syndrome. AJR Am J Roentgenol. 2009; 193: 549-558. doi: 10.2214/AJR.08.1904

Varricchio C. Clinical management of superior vena cava syn-drome. Heart Lung.1985; 14(4): 411-416.

Kalra M, Sen I, Gloviczki P. Endovenous and operative treat-ment of superior vena cava syndrome. Surg Clin North Am. 2018; 98(2): 321-335. doi: 10.1016/j.suc.2017.11.013 Submit your article to this journal | https://openventio.org/submit-manuscript/

Ratnarathorn M, Craig E. Cutaneous findings leading to a di-agnosis of superior vena cava syndrome: A case report and review of the literature. Dermatol Online J. 2011; 17(6): 4. doi: 10.5070/ D37kw6z5kj

Johnson JS, Kotora J, Bechtel B. Superior vena cava syndrome masquerading as an allergic reaction. Am J Emerg Med. 2012; 30(9): 2100.e1-e3. doi: 10.1016/j.ajem.2012.02.006

Sofue K, Takeuchi Y, Arai Y, Sugimara K. Life-threatening ce-rebral edema caused by acute occlusion of a superior vena cava stent. Cardiovasc Intervent Radiol. 2013; 36 (1): 272-275. doi: 10.1007/ s00270-012-0421-1

Parikh R, Stanley J, Tandon R. Superior vena cava syndrome masquerading as Angioedema. J Intensive & Crit Care. 2016, 2: 1-3. doi: 10.21767/2471-8505.100024

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Published

2023-04-24

How to Cite

Paul R. Henning, & Larry B. Mellick. (2023). Emergency Department Diagnosis and Management of Superior Vena Cava Syndrome Secondary to Hodgkin’s Lymphoma: Case Report and Limited Literature Review of Emergency Department Management. Emergency Medicine, 9(2), 33–38. https://doi.org/10.17140/EMOJ-9-171

Issue

Vol. 9 No. 2 (2023): Volume 9 Issue 2 2023

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Articles

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