Abstract
Superior vena cava syndrome （SVCS）, as a potentially life-threatening oncologic emergency condition, is a group of congestive symptoms caused by the obstruction of the superior vena cava （SVC）. The main cause of SVCS is malignant tumors in the mediastinum, most commonly lung cancer. SVCS caused by oral cancer is rare. Here we describe a case of SVCS caused by secondary metastasis to a deep cervical lymph node in the supraclavicular fossa from lower gingival cancer.
A 77-year-old woman with lower gingival squamous cell carcinoma, T2N0M0, was surgically treated by marginal mandibulectomy with supraomohyoid neck dissection. Four years after the primary operation, metastasis to the level Ⅳ lymph node in the ipsilateral neck occurred. The tumor was palliatively irradiated with a total dose of 50Gy. Six months after the radiation, sudden edema developed on the ipsilateral face, neck, and arm accompanied with hoarseness, coughing, and headache. A CT revealed collapse of the SVC due to enlargement of the metastatic lymph node where the jugular vein and the subclavicular vein join to the brachiocephalic vein. Although the congestive condition was temporarily improved with administration of steroid and glycerol, the patient died at home 47 days after development of SVCS.
