uperior vena cava syndrome (SVCS) was first
described in l757 in a patient with a syphilitic
lesion of the aorta.
1
The causes of SVCS have
changed since that time. In the 1950s, SVCS was
primarily caused by aortic aneurysm and infections
such as tuberculosis and fibrous mediastinitis. In the
1980s and 1990s, malignant disorders have become the
dominant cause of SVCS. In most patients with SVCS,
primary malignancies of the mediastinum are the
causative factor. Benign disorders account for less than
10% of cases of SVCS. Modern antibiotic treatment of
infectious disorders is postulated to be the cause of the
changing etiologies of SVCS.
2 –11
This article reviews the
anatomy of the superior vena cava and the pathophysi-
ology, malignant and benign causes, clinical presenta-
tion, and diagnosis of SVCS. Treatment and prognosis
are also discussed.