ที่มา : //www.medicine.cmu.ac.th/dept/radiology/cur/มะเร็งปอด_ศ.วิมล.doc

โดย : ศ.พ.ญ.วิมล สุขถมยา

SVC syndrome
เป็น Medical emergency สาเหตุ
85% bronchogenic carcinoma
10% malignant lymphoma
3% goiter

การรักษา
NSCLC : Radiotherapy :
Mediastinal + hilar nodes
with any parenchymal lesions
Excellent symptomatic relief

SCLC
- RT + Chemo
- Chemo

Pancoast tumors
Associated with rib destruction and perineural invasion

การรักษา Pain : Relieved by RT
Preop : RT

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Superior vena cava syndrome

Reference : //en.wikipedia.org/wiki/Superior_vena_cava_syndrome (From Wikipedia, the free encyclopedia)

Superior vena cava syndrome (SVCS), or superior vena cava obstruction (SVCO), is usually the result of the direct obstruction of the superior vena cava by malignancies- such as compression of the vessel wall by right upper lobe tumors and/or mediastinal lymphadenopathy. The most common malignancies that cause SVCS is non small cell lung cancer and small-cell lung cancer. It can also occur as a result of thrombosis in the SVC, although this is less common (approximately 35% due to the use of intravascular devices).[1] It is often clinically striking but very seldomly requires emergency intervention. Clinical symptoms may develop over several weeks or longer. Increased venous pressure leads to edema of the head, neck, and arms and may turn the patient a shade of blue with cyanosis. Other common symptoms include distention in the neck and chest veins and flushing. Edema may impede the function of the larynx or pharynx resulting in cough, dyspnea, dysphagia, and stridors. Cerebral edema may lead to mental status changes such as confusion, coma, or migraines. Cerebral edema is rare, but if it occurs it may be fatal. [1][2]


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Pancoast tumor

Reference : //en.wikipedia.org/wiki/Pancoast_tumor (From Wikipedia, the free encyclopedia)

A pancoast tumor or superior sulcus tumor, is a tumor of the pulmonary apex i.e. a type of lung cancer defined primarily by its location situated at the top end of either the right or left lung.

The growing tumor can cause compression of a brachiocephalic vein, subclavian artery, phrenic nerve, recurrent laryngeal nerve, vagus nerve, or, characteristically, compression of a sympathetic ganglion resulting in a range of symptoms known as Horner's syndrome.

Pancoast tumors are named for Henry Pancoast, a US radiologist, who described them in 1924 and 1932.[1]