Hodgkin Lymphoma-Associated Superior Vena Cava Syndrome: A Case Report and Review of the Literature

Abstract

Patient: Male, 53-year-old Final Diagnosis: Hodgkin lymphoma • superior vena cava syndrome Symptoms: Dry cough • dyspnea • facial edema • fatigue Medication: — Clinical Procedure: — Specialty: Hematology • Oncology Objective: Rare co-existance of disease or pathology Background: Hodgkin lymphoma (HL) is a relatively rare etiology of superior vena cava (SVC) syndrome, with only 24 cases reported in the literature. The characteristics, management, and prognosis of HL-associated SVC syndrome remain unclear. This case report describes nodular sclerosis classical HL and the associated clinical manifestations presenting as SVC syndrome in a middle-aged patient, and it summarizes the characteristics of HL-associated SVC syndrome. Case Report: In this case report, we present a 53-year-old Hispanic man with progressively worsening dyspnea, dry cough, facial and neck edema, and dysphagia. SVC syndrome was diagnosed, and pathology revealed nodular sclerosis classical HL. The patient was treated with doxorubicin, bleomycin, vinblastine, and dacarbazine. SVC syndrome improved, and repeated imaging showed that the lymphoma had decreased in size and had become metabolically inactive. Conclusions: We reviewed the characteristics, management, and prognosis of HL-associated SVC syndrome, which may indicate more advanced and recurrent progression in patients with HL. This possibility suggests that physicians should provide urgent diagnosis and closer follow-up, and more aggressive therapies may be needed because of the high risk of recurrence. Therapy may induce late-onset SVC syndrome in patients with HL.

Superior Vena Cava Syndrome: An Update and Literature Review of Percutaneous Endovascular Treatments

“…5 Additionally, steroids may have a role in treating hematologic malignancies such as Hodgkin lymphoma, but they may complicate the posttreatment biopsy results because of their cytotoxic effects on cells. 21 Steroids have been reported as the first line for pediatric cases of SVCS with lymphoma as well as patients with fibrosing mediastinitis. 13 22 The benefit of steroids alone in the treatment of SVCS is questionable, and some even reported poor outcomes associated with the steroid use.…”