We report a case of carcinoma of the lower lip with superior vena cava syndrome(SVCS)due to secondary metastasis to the mediastinal lymph nodes. The patient, a 77 year-old woman, was referred to our department to treat a tumor in the right side of the lower lip. Histologic examination of a biopsy specimen revealed a well-differentiated squamouse cell carcinoma. The tumor was abraded by en bloc excision surgery with bilateral neck dissection under general anesthesia. Further histological evaluation of an excised specimen revealed a diagnosis of pN2c. Six months later the cancer recurred locally in the left corner of the patient' s mouth, and the tumor was removed surgically. Eight months later, edema suddenly developed on the left side of the face, neck, forearm, and back of hand, accompanied by dizziness. A computed tomographic scan of the patient' s chest revealed metastasis to the left mediastinal lymph nodes, with occlusion of the left internal jugular vein, brachiocephalic veins, and respiratory tract. The occulded veins were attributed to compression of the superior vena cava by a metastatic tumor. SVCS should be considered whenever edema of the face appears after neck dissection.

Abstract:A 47-year-old man was refered to us because of maxillary sinusitis associated with homogenous