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病例报告:揭开一例散发性小儿肿瘤急症的面纱:上腔静脉综合征。

Case Report: Unmasking a sporadic pediatric tumor emergency: superior vena cava syndrome.

作者信息

Liu Gui-Liang, Wang Min, Zhang Min, Dai Yan, Zhang Di-Wen

机构信息

Department of Pediatrics, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.

出版信息

Front Pediatr. 2025 Mar 7;13:1517745. doi: 10.3389/fped.2025.1517745. eCollection 2025.

Abstract

INTRODUCTION

Superior Vena Cava Syndrome (SVCS) is a rare but serious oncologic emergency in pediatric patients, most commonly caused by mediastinal masses such as lymphomas or leukemias. This condition results from the obstruction of the superior vena cava (SVC), leading to impaired venous return and respiratory and cardiovascular complications, progressive exacerbation in a short period, and an extremely high fatality rate. We report the case of a 12-year-old boy with SVCS caused by a mediastinal mass.

MAIN SYMPTOMS/FINDINGS: The patient presented with progressive dyspnea, orthopnea, and swelling of the head and neck. He also exhibited chest tightness, dry cough, and shortness of breath. A chest CT revealed a large anterior mediastinal mass compressing the SVC and main bronchi.

DIAGNOSIS TREATMENT OUTCOMES

The patient was diagnosed with SVCS secondary to T-cell lymphoblastic lymphoma. Treatment began immediately with oxygen therapy and intravenous dexamethasone to reduce mediastinal compression. Significant clinical improvement was observed within 48 h, with a reduction in dyspnea and swelling. A biopsy confirmed T-cell lymphoblastic lymphoma and multidisciplinary care was pivotal to successful management.

CONCLUSION

Early recognition and treatment of pediatric SVCS are essential to prevent life-threatening complications. Combined with a multidisciplinary approach, corticosteroid therapy was crucial for the patient's rapid recovery. Further research is needed to optimize treatment protocols and improve outcomes for pediatric SVCS cases.

摘要

引言

上腔静脉综合征(SVCS)在儿科患者中是一种罕见但严重的肿瘤急症,最常见的病因是纵隔肿块,如淋巴瘤或白血病。这种情况是由于上腔静脉(SVC)阻塞所致,导致静脉回流受损以及呼吸和心血管并发症,在短时间内病情逐渐加重,病死率极高。我们报告一例由纵隔肿块引起SVCS的12岁男孩病例。

主要症状/发现:患者出现进行性呼吸困难、端坐呼吸以及头颈部肿胀。他还表现出胸闷、干咳和呼吸急促。胸部CT显示一个巨大的前纵隔肿块压迫SVC和主支气管。

诊断、治疗结果:患者被诊断为继发于T细胞淋巴母细胞淋巴瘤的SVCS。立即开始进行氧疗和静脉注射地塞米松以减轻纵隔压迫的治疗。48小时内观察到显著的临床改善,呼吸困难和肿胀减轻。活检确诊为T细胞淋巴母细胞淋巴瘤,多学科护理对成功治疗至关重要。

结论

早期识别和治疗儿科SVCS对于预防危及生命的并发症至关重要。结合多学科方法,皮质类固醇治疗对患者的快速康复至关重要。需要进一步研究以优化治疗方案并改善儿科SVCS病例的治疗结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf16/11926146/8cc445304dca/fped-13-1517745-g001.jpg

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