Definition

SVC obstruction is a narrowing or obstruction of the superior vena cava -- the major vein draining the upper body.

Alternative Names

Superior vena cava obstruction; Superior vena cava syndrome

Causes

Superior vena cava (SVC) obstruction is a relatively rare condition. Most often it is caused by one of several cancers that can be found in the mediastinum (the area of the chest under the breastbone and between the lungs).

These include lymphomas, cancer of the lung with extension into the mediastinum, breast cancer, testicular cancer, thyroid cancer, and thymic tumors. Superior vena cava obstruction can also be caused by noncancerous conditions that cause chronic fibrosis (scarring).

These include lung infections, such as tuberculosis, histoplasmosis infection, and thrombophlebitis (particularly extension of thrombophlebitis of superficial veins or the subclavian vein). Other causes of superior vena cava obstruction include aortic aneurysm, constrictive pericarditis, and goiter.

Symptoms

neck swelling, facial swelling, or arm swelling
swelling around the eye socket (periorbital)
sensation of head or ear "fullness"
reddish face or cheeks
reddish palms
reddish mucous membranes (inside the nose, mouth, and so on)
redness changing to blueness later
headache
dizziness
vision changes
fainting
decreased alertness

Note: Symptoms may begin suddenly or gradually, and may worsen when bending over or lying down.

Exams and Tests

An examination may show dilated cutaneous (skin) veins of the face, neck, and upper chest. Blood pressure is often high in the arms and low in the legs.

A bronchoscopy may be performed if lung cancer is suspected.

Obstruction of the SVC may show on:

This disease may also alter the results of the following tests:

liver scan
abdominal MRI

Treatment

The goal of treatment is relief of the obstruction.

Diuretics may be used to relieve swelling.

The cause must be identified and treated. This may include radiation, chemotherapy, surgical removal of tumors, or other treatment. Surgery to bypass the obstruction is rarely performed. Placement of a stent to open up the SVC is available at some medical centers.

Outlook (Prognosis)

The outcome varies depending on the cause and the extent of obstruction.

Possible Complications

The throat could swell and block the airways.

When to Contact a Medical Professional

Call your health care provider if alung tumor is present and symptoms indicate SVC obstruction may be present. Complications are serious and can sometimes be fatal.

Prevention

Prompt treatment of causative disorders may reduce the risk of development of SVC obstruction.