Vena cava superior syndrome in malignant pleural mesothelioma

Malignant pleural mesothelioma is a fatal tumour of the pleura caused by asbestos exposure. Trombocytosis is a frequently seen paraneoplastic syndrome of this disease but vena cava superior syndrome (VCSS) is very rarely reported.

A 51 year old man living in Dicle presented with dyspnea, chest pain and weight loss. The history of the patient revealed 50 years environmental asbestos exposure. In the chest x-ray, pleural thickening of the right hemithorax and pleural effusion were detected. Pleural biopsy was done and malignant pleural mesothelioma was diagnosed. In the first thorax CT, vena cava superior (VCS) was detected normal. For the pleurodesis pleurocain was applied. In the 15 th day of the follow-up, the patient presented with edema of the head, neck, upper side of the chest and upper extremities so control thorax CT was taken for the suspicion of VCS syndrome (VCSS) caused by the invasion of the tumour but thrombus was found in the vena cava superior. Blood parameters showed no abnormalities for venous thrombosis. Treatment was started for the thrombus
but the patient died a month later.

During the follow-up of malignant pleural mesothelioma patients, if vena cava superior syndrome occurs, obstructive lesions like thrombus should be considered as well as the invasion of this vessel by the tumour.

Habis plevral mezotelyomada vena kava superior sendromu