Seki Y, Ishida I
Division of Thoracic diseases, Chiba Cancer Center Hospital, Japan.
Rinsho Kyobu Geka. 1989 Dec;9(6):575-7.
Superior vena cava syndrome is commonly caused by malignant diseases such as lung cancer, malignant lymphoma and so forth. It is uncommon that benign diseases obstruct the superior vena cava or its major tributaries. But there are some documented cases of benign superior vena cava syndrome induced by mediastinitis, benign mediastinal tumors, and uncommon lesions having their primary origin in the mediastinum. A 41-year-old male patient had recognized his ptotic palpebra two years ago and chest roentgenographic examination disclosed a tumor shadow occupying the apex of the right thorax but he was almost asymptomatic except venous dilatation of the anterior chest wall. Venography revealed obstruction of the brachiocephalic vein and superior vena cava. At thoracotomy the tumor was found to be impacted at the apex of the thoracic fornix and to be cystic. Primary site of the tumor was at the chest wall and its histological finding was compatible with that of neurilemmoma. Postoperative venography confirmed complete patency of the brachiocephalic vein and superior vena cava.
上腔静脉综合征通常由肺癌、恶性淋巴瘤等恶性疾病引起。良性疾病阻塞上腔静脉或其主要分支并不常见。但有一些文献记载的病例显示,纵隔炎、良性纵隔肿瘤以及起源于纵隔的罕见病变可导致良性上腔静脉综合征。一名41岁男性患者两年前发现上睑下垂,胸部X线检查显示右胸尖有一个肿瘤阴影,但除前胸壁静脉扩张外,他几乎没有症状。静脉造影显示头臂静脉和上腔静脉阻塞。开胸手术时发现肿瘤嵌顿于胸廓穹窿尖部,呈囊性。肿瘤的原发部位在胸壁,组织学检查结果与神经鞘瘤相符。术后静脉造影证实头臂静脉和上腔静脉完全通畅。