title: HIV complicates the management of oncological emergencies: a case involving the superior vena cava syndrome.
abstract: An association exists between human immunodeficiency virus (HIV) and an increased incidence of lung cancer. Superior vena cava syndrome (SVCS) is an oncological emergency seen in the presence of chest tumours. We report on an otherwise well HIV-positive male who presented with SVCS due to lung cancer. He was commenced on dexamethasone and radiotherapy with curative intent. Treatment was complicated by accelerated steroid- and radiation-induced morbidity. The patient died of disseminated aspergillosis after receiving 27 of 35 planned radiotherapy fractions. The management of SVCS in those with HIV is challenging and requires the judicious use of steroids, antifungal prophylaxis and palliative radiotherapy doses.
authors.affiliation: London Regional Cancer Centre, University of Western Ontario, London, Ontario, Canada. gvidetic@lrcc.on.ca
authors.forename: G M
authors.initials: GM
authors.lastname: Videtic
authors.forename: W I
authors.initials: WI
authors.lastname: Kocha
authors.forename: R A
authors.initials: RA
authors.lastname: Malthaner
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications* / Q000532:radiotherapy; D003907:Dexamethasone / Q000009:adverse effects / Q000627:therapeutic use; D017809:Fatal Outcome; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000532:radiotherapy; D008297:Male; D013479:Superior Vena Cava Syndrome / Q000188:drug therapy / Q000209:etiology* / Q000532:radiotherapy
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone