Superior vena cava syndrome as tumour presentation.
Superior vena cava syndrome (SVCS) is characterised by gradual and insidious compression/obstruction of the superior vena cava (SVC). Upper chest and neck ingurgitation, plethoric face and oedema are the common symptoms/signs. It generally means the presence of neoplasm, namely lung cancer.


OBJECTIVE
Retrospective analysis of the patients admitted to S. João Hospital, Porto, Portugal, January 1995-December 2006 with SVCS without previous diagnosis. Patients, tumour characteristics and prognostic factors were studied.


METHODS
Data was collected by consulting the clinical files of 60 SVCS patients without previous diagnosis. Data was gathered on the patients' demographic characteristics (age, gender, smoking habits), performance status, histology, staging, treatment and overall survival.


RESULTS
Lung cancer was observed in 87% of the patients. Small-cell lung cancer (SCLC) was the most frequent histological type; 41% of the patients. It is noticeable that 10% were diagnosed with non- Hodgkin's lymphoma. In terms of prognostic factors analysed, the absence of metastasis, the lymphoma's histological diagnosis, good performance status and non-smoker status were positively correlated with the survival rate. On the contrary SCLC was significantly correlated with a worse survival.


CONCLUSIONS
In our analysis we concluded that SCLC, smokers and a poorer performance status as well as metastatic disease were unfavourable prognostic factors to SVCS as tumour presentation.
Pires
Nuno Filipe
NF
Serviço de Pneumologia, Hospital S. João, Alameda Prof. Hernâni Monteiro, 4202 -451 Porto. nunofxpires@gmail.com
Morais
António
A
Queiroga
Henrique
H
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013479:Superior Vena Cava Syndrome / Q000209:etiology* / Q000401:mortality; D015996:Survival Rate; D055815:Young Adult