Abstract
Invasive fungal infection （IFI） is a systemic fungal infection that develops due to immune depression, and superior vena cava syndrome （SVCS） is a syndrome caused by obstruction of the superior vena cava. We experienced a case of IFI due to the treatment of SVCS caused by tongue cancer.
A 67-year-old man with tongue squamous cell carcinoma, cT3N2bM0, was surgically treated by partial hemiglossectomy and modified radical neck dissection. Five months after postoperative adjuvant therapy, nivolumab was started because metastatic lymph nodes were found in the cervical region. Two years thereafter, metastatic lymph nodes were found in the superior mediastinal region, and chemotherapy was planned, but edema in the head and neck and malaise appeared because of stenosis of the superior vena cava. The patient’s symptoms improved with radiotherapy and steroid administration, but two months after the start of chemotherapy, he developed a persistent fever that did not respond to antibiotics. Although no fungi were detected in the blood culture, we diagnosed IFI （probable diagnosis） based on long-term steroid administration, nodular lesions in the lungs, and elevated β-D glucan levels. Voriconazole was administered, which resulted in an improvement in the symptoms. Chemotherapy was resumed, but his general condition worsened, and he died five months after the onset of IFI.
