Long-term survival after superior vena cava resection and reconstruction for bulky local recurrence from lung cancer.

A 65-year old man who had undergone right pneumonectomy for lung cancer presented with superior vena cava (SVC) syndrome due to recurrent bulky disease on follow-up after 14 months. Complete resection of the tumour was achieved, and the SVC system was reconstructed with separated double grafts. The right graft was anastomosed between the SVC and the right subclavian vein, because the right brachiocephalic vein was involved by the tumour. Graft-subclavian vein anastomosis was created in the extra-thoracic portion. Although postoperative right graft occlusion occurred, right arm oedema improved conservatively. He is alive, well and has been disease-free for 39 months since the second surgery. This is the first report of SVC resection and reconstruction for 'recurrent' disease from lung cancer. Extended resection for recurrent disease should not be excluded as a treatment option.