What are the common causes of superior vena cava compression in tumors

Superior vena cava compression is commonly seen in lung cancer, lymphoma, thymoma, metastatic tumors, and mediastinal germ cell tumors. This symptom is often caused by direct compression of the tumor or lymph node metastasis leading to obstruction of superior vena cava return, and requires a combination of imaging and pathological examination for diagnosis. Lung cancer is the most common cause of superior vena cava compression syndrome, especially central type lung cancer. When tumors grow in the upper lobe or mediastinum of the right lung, they are prone to invade the superior vena cava, and patients may experience symptoms such as facial swelling, jugular vein engorgement, and cough. Diagnosis relies on chest enhanced CT or PET-CT, and treatment mainly involves chemotherapy combined with radiotherapy. If necessary, vascular stent implantation may be performed to alleviate symptoms. Non Hodgkin lymphoma is more likely to cause superior vena cava compression in lymphoma, and mediastinal lymph node enlargement can directly compress blood vessels. Typical symptoms include difficulty breathing, headache, and upper limb edema, and some patients may have B symptoms such as fever and night sweats. Pathological biopsy can clarify the classification, and the treatment plan should be based on the type of lymphoma, selecting targeted drugs or immunotherapy. Thymoma and mediastinal germ cell tumors are relatively rare, but caution should be taken. Thymoma is more common in the anterior mediastinum, and about one-third of patients have myasthenia gravis. Enhanced MRI can help evaluate the relationship between the tumor and blood vessels. Genital cell tumors are more common in young men, and serum alpha fetoprotein and chorionic gonadotropin testing have diagnostic value. Surgery combined with radiotherapy and chemotherapy can improve prognosis.

Mediastinal metastasis of metastatic tumors such as breast cancer and thyroid cancer can also cause this symptom. Breast cancer metastasis is often accompanied by axillary lymph node enlargement, thyroid cancer metastasis is mostly from undifferentiated cancer. On the basis of primary lesion treatment, palliative radiotherapy or interventional therapy should be performed for superior vena cava compression, while monitoring the risk of thrombosis. When symptoms of superior vena cava compression occur, upper limb infusion should be avoided and a semi recumbent position should be adopted to reduce edema. Daily low salt diet is required to control fluid intake and monitor respiratory and consciousness status. After diagnosis, it is advisable to seek medical treatment as soon as possible for anti-tumor therapy. Late stage patients may consider palliative care to improve their quality of life.