Superior vena cava syndrome associated with childhood malignancy: Analysis of 24 cases

Abstract

Twenty‐four children with superior vena cava obstruction at initial presentation or associated with disease recurrence were treated at St. Jude Children's Research Hospital from 1973 to 1988. Of the 16 patients with superior vena cava syndrome at presentation, eight had non‐Hodgkin's lymphoma, four had acute lymphoblastic leukemia, two had Hodgkin's disease, one had neuroblastoma, and one had a yolk sac tumor. Their clinical condition at presentation was often critical and required rapid treatment. In all cases, histopathologic diagnosis was obtained without complication by either bone marrow aspiration, lymph node biopsy, thoracentesis, or thoracotomy prior to the initiation of definitive therapy. Eight children had superior vena cava syndrome as a late complication during the course of their therapy. None had an antecedent history of superior vena cava obstruction. In contrast to the patients with superior vena cava obstruction at presentation, this group was composed predominantly of patients with recurrent solid tumors. Other causes included disseminated candidiasis and superior vena cava thrombosis, thus underscoring the importance of recognizing the etiology of superior vena cava syndrome to facilitate proper treatment.

Emergent/urgent therapeutic irradiation in pediatric oncology: Patterns of presentation, treatment, and outcome

“…That syndrome differs from the superior vena cava syndrome (SVCS) in that tracheal compression is added to the SVCS signs and symptoms. The combination of signs is so often present in children that the two terms are used interchangeably [8,12]; in contrast, the SVCS is more common in adults, usually from lung cancer (65%) [6]. Non-Hodgkin's lymphoma accounts for about 70% of pediatric SMS/SVCS in other series [6,8,13], but among our patients, non-Hodgkin's lymphoma was the cause in only 25% (3 of 12).…”

“…The diseases responsible for these syndromes differ between adult and children, as does their clinical evolution [6]. Oncologic emergencies generally presented earlier in the course of the disease in children, may often be the presenting symptom [7][8][9], and do not necessarily carry the grim prognosis that characterizes adult emergencies [2,4,[8][9][10][11]. In addition, cancers in children tend to be more chemosensitive and radiosensitive than those in adults.…”

Radioterapia paliativa en niños: presentación de un caso clínico y recuerdo de sus indicaciones

“…La afectación de la vena cava [28][29][30][31] por una masa tumoral mediastínica que la infiltra o la comprime, es considerada una urgencia oncológica, que al igual que la compresión medular exige un rápido diagnósti-co cuando se sospecha clínicamente: sudoración, plé-tora y cianosis facial, inyección subconjuntival, edema en "esclavina", incremento de la vascularización sublingual, circulación colateral y posibilidad de aparición de síntomas respiratorios y digestivos con disnea, distress respiratorio y disfagia. Al igual que la compresión medular, es también infrecuente en niños, siendo la primera causa la yatrogénica, relacionada con cirugía cardiovascular o complicaciones de cateterizaciones.…”

Suporte de terapia intensiva no paciente oncológico

“…Mediastinal masses can also compress the trachea and upper airways causing respiratory insufficiency. 29 The patient presents facial edema with venous engorgement and sometimes neurological symptoms (stupor and seizures). The chest X-ray shows mediastinal enlargement and deviation of structures, especially of the trachea.…”