Podsumowanie

Chociaż ZŻGG nie jest zbyt częstym schorzeniem, jego objawy są nierzadko dramatyczne. Wymaga to umiejętnego ustalenia rozpoznania na podstawie objawów i wyników badań diagnostycznych zarówno przez lekarza podstawowej opieki zdrowotnej, jak i przez personel szpitalny. Tylko wtedy zastosowanie właściwego leczenia przyczynowego równolegle z terapią objawową pozwoli poprawić wyniki leczenia tej jednostki chorobowej.

ABSTRACT

Superior vena cava syndrome – clinical presentation, diagnostics and treatment

Superior vena cava syndrome (SVCS) is a rare cluster of symptoms and signs caused mainly by thoracic neoplastic diseases. Occlusion of blood flow from upper body results in a characteristic clinical appearance of facial, upper chest and hand oedema, cyanosis, and skin vessel engorgement. This is accompanied by dyspnoea that worsens when leaning. Computed tomography is the diagnostic gold standard for evaluation of internal thoracic organs as well as confirmation of vena cava thrombosis. There are two treatment goals: elimination of the cause of SVCS (chemotherapy, radiotherapy, surgery, antibiotics) and symptomatic relief (oxygen delivery, steroids, thrombolytic therapy and stent placement). The prognosis depends on the underlying cause.

Piśmiennictwo

1. Hunter W. The history of an aneurysm of the aorta with some remarks on aneurysms in general. Med Obs Enq 1757;1:323-57

2. Schechter MM. The superior vena cava syndrome. Am J Med Sci 1954;227(1):46-6

3. Straka Ch. Review of evolving etiologies, implications and treatment strategies for the superior vena cava syndrome. Springer Plus 2016;5:229

4. Drews RE, Rabkin DJ. Malignancy-related superior vena cava syndrome. UpToDate 2017

5. Bochenek A. Anatomia człowieka. Tom III. Wydanie IX. PZWL, Warszawa 2012:393-4

6. Rolski W, Kiprian D. Opis przypadku zespołu żyły głównej górnej. Med Paliat 2012;2:90-4

7. Pech-Alonso B. Superior vena cava syndrome: Clinical considerations. Rev Med Hosp Gen Mex 2018;81(2):59-65

8. Paraschiv B. Superior vena cava syndrome. Archiv Balkan Med Union 2017;52(1):39-43

9. Keshvani N. Pemberton’s sign in SVC syndrome from metastatic renal cell carcinoma. BMJ Case Rep 2018. doi:10.1136/bcr-2018-22419

10. Yu JB, Detterbeck FC. Superior vena cava syndrome: a proposed classification system and algorithm for management. J Thorac Oncol 2008;3:811-4

11. Ramirez JMC. Superior vena cava syndrome. J Cardiol Curr Res 2018;1(6)

12. Sculier JP. Superior vena cava obstruction syndrome in small cell lung cancer. Cancer 1986;57:847-51

13. Loeffler JS. Emergency prebiopsy radiation for mediastinal masses: impact on subsequent pathologic diagnosis and outcome. J Clin Oncol 1986;4(5):716

14. Armstrong BA. Role of irradiation in the management of superior vena cava syndrome. Int J Radiat Oncol Biol Phys 1987;13(4):531-9

15. Talapatra K. Superior vena cava syndrome: A radiation oncologist’s perspective. J Can Res Ther 2016;12:515-9

16. Mahajan V, Strimlan V, Ordstrand HS, et al. Benign superior vena cava syndrome. Chest 1975;68(1):32-5

17. Sfyroeras GS. A review of open and endovascular treatment of superior vena cava syndrome of benign aetiology. Eur J Vasc Endovasc Surg 2017;53(2):238-54

18. Rizvi AZ. Benign superior vena cava syndrome: Stenting is now the first line of treatment. J Vasc Surg 2008;47:372-80

19. Bustgens F. Stent implantation for superior vena cava syndrome of malignant cause. Fortschr Rontgenstr 2017;189:423-30

20. Wei S. A retrospective stenting study on superior vena cava syndrome caused by lung cancer. Thorac Cancer 2020;11(7):1835-9

Do góry