Superior vena cava syndrome. Clinical management.

Superior vena cava syndrome (SVCS) is an acute or subacute oncologic emergency with typical clinical features. The syndrome is almost invariably secondary to a malignant process. The treatment of choice is irradiation, but in resistant cases or in those instances in which radiation tolerance is achieved, either surgery or chemotherapy, or both, may play a crucial role. The major pitfalls in management relate to attempts to establish the site of obstruction and to obtain specific tissue diagnosis.