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.

Keywords: Metastatic urothelial cancer; Superior vena cava syndrome; urothelial cancer.

Figure 1

Abdominal enhanced computerized tomography scan revealing tumors in the left renal pelvis and ureter

Figure 2

Chest CT revealing multiple tumors in the lung fields and enlargement of lymph nodes at the right side of the lung hilum and trachea, anterior mediastinum and bilateral supraclavicular fossae. Massive lymph nodes in the right mediastinum constricted the upper part of the superior vena cava and merging section of bilateral brachiocephalic veins

Figure 3

Irregularly sized transitional cells with nuclear pleomorphism forming a papillary structure