[A case of superior vena cava syndrome caused by adenocarcinoma of the mediastinum--the significance of pulsed Doppler echocardiography in the SVC reconstruction].

We report a case of SVC syndrome caused by adenocarcinoma of the mediastinum, in which brachiocephalic vein flow was recorded by pulsed Doppler echocardiography before and after the SVC reconstruction. A 46-year-old man was admitted to the hospital with the chief complaints of edema of the face and the upper extremities. Although chest X-ray film showed no abnormalities, chest CT and SVC-graph demonstrated the obstruction of SVC and bilateral brachiocephalic veins. It was found that bilateral brachiocephalic vein flow displayed characteristic one-peak shaped pattern and the peak flow velocity was decreased. We removed SVC and bilateral brachiocephalic veins with the surrounding tissue, and SVC and tributaries were reconstructed with 10 mm ringed ePTFE grafts. Histological examination revealed carcinoma cell infiltration in the wall of SVC. Postoperative phlebography showed well patent grafts, and bilateral brachiocephalic vein flow pattern normalized and the peak flow velocity remarkably increased.