Superior vena cava syndrome due to metastasis from urothelial cancer: A case report and literature review

Abstract

Superior vena cava (SVC) syndrome is caused by compression or obstruction of the SVC. We report here in a case of SVC syndrome due to lymph node metastasis from urothelial cancer to the mediastinum and lung. The origin of metastasis was determined by computed tomography (CT)-guided biopsy of metastases. After radiotherapy to the mediastinum with glucocorticoid failed, anticancer pharmacotherapy including paclitaxel, gemicitabine, and cisplatin proved effective and SVC syndrome resolved. But patient died from cerebral bleeding from newer brain metastases 10 months later.

Mediastinum Lymph Node Metastasis with Superior Vena Cava Syndrome

“…Concerning SVCS therapies, many of the causable diseases of SVCS are malignant tumors. Radiotherapy, chemotherapy with anticancer drugs, and single or combined surgical therapy are usually selected [2,5,6]. Liu H, et al [7] reported that, for SVCS caused by malignant tumors, percutaneous endoluminal stent therapy could quickly and effectively relieve the clinical symptoms of patients, and the incidence…”

“…The prognosis of SCVS due to malignant tumors is not good. Wakeda H, et al [5] discussed about the treatment of SVCS as follows. Management for SVCS associated with a malignant condition involves both treatment of the cancer and relief of the obstructive symptoms.…”

Urothelial Superior Vena Cava Syndrome with Limited Response to Radiation Therapy

“…Treatment was switched to paclitaxel, gemcitabine, and cisplatin which decreased the offending tumor size by 90%. The patient died 10 months later due to bleeding from a brain metastasis [ 8 ]. None of the other cases survived more than one month, although one had initial improvement with chemoradiation [ 9 – 11 ].…”