Palliative endovascular stenting for superior vena cava syndrome improved end-of life quality of life in a patient with acute myeloid leukemia

Abstract

A palliative stent implantation was performed for malignant superior vena cava (SVC) syndrome (SVCS) in a patient with acute myeloid leukemia (AML). A 13-year-old boy with AML underwent allogeneic peripheral blood stem cell transplantation from his HLA-haploidentical mother. Despite post-transplantation treatment, an extramedullary mediastinal tumor developed after nine months. Tumor progression resulted in SVCS, presenting as severe bilateral upper extremity edema and dyspnea. Radiotherapy achieved partial tumor regression within a few days; however, symptoms persisted. Endovascular stenting of the bilateral brachiocephalic veins extending into the SVC was performed, leading to rapid symptom resolution. Preserved SVC patency enabled the maintenance of functional use of the hands until the patient died after three months from leukemia progression. Endovascular stenting is a useful palliative treatment option for malignant SVCS, enhancing quality of life in patients with cancer.