Superior vena cava syndrome caused by supraclavicular lymph node metastasis of renal cell carcinoma.
A 65-year-old woman presented with gross hematuria in February 1997. Left renal tumor was revealed and radical nephrectomy was performed. Pathological examination revealed papillary renal cell carcinoma, pT3aN1M1 (ipsilateral adrenal gland). Interferon-alpha was administered for 1 year. Two years after the nephrectomy, metastasis to the left supraclavicular lymph node appeared. Seven years after the nephrectomy, the metastatic tumor invaded the brachiocephalic vein and extended to the superior vena cava (SVC), compatible with SVC syndrome. Although interferon-alpha and external-beam radiotherapy was performed, she died in February 2005. Autopsy revealed a left supraclavicular lymph node metastasis invading the thyroid gland, mediastinum, and brachiocephalic vein. The tumor thrombus descended via the SVC into the right atrium. The right lung artery was obstructed by tumor thrombus. There were no visceral metastases and no local recurrence.
Sakura
Mizuaki
M
Department of Urology, Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan. m-sakura.uro@tmd.ac.jp
Tsujii
Toshihiko
T
Yamauchi
Akimasa
A
Tadokoro
Manabu
M
Tsukamoto
Tetsuro
T
Kawakami
Satoru
S
Yonese
Junji
J
Fukui
Iwao
I
D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage; D002292:Carcinoma, Renal Cell / Q000556:secondary*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage; D007680:Kidney Neoplasms / Q000473:pathology*; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D011878:Radiotherapy; D013479:Superior Vena Cava Syndrome / Q000209:etiology*
D000998:Antiviral Agents; D016898:Interferon-alpha