Neoplastic superior vena cava obstruction: combined approach.

Primary adult cardiac tumors are rare entities with a low indices. In 90% of cases are benign. Among malignant tumors angiosarcomas are the most common. In 80% of cases they arises in the right atrium, more often in younger males as compared to benign tumors. The majority of them manifests as locally already advanced disease, precluding macroscopically complete surgical resection. Moreover, the presence of macro- and micrometastasis makes the prognosis always prohibitive. The duration of symptoms is in the order of months and the median survival ranges from 6 to 11 months. Death cause is usually a complication of locally recurrent disease: tamponade, hemopericardium are common. Treatment is multidisciplinary. The combination of chemo- and radiotherapy with surgery aims to increase survival. In the management of unresectable tumors, due to anatomic reason or Iocoregional spread, an important role is played by pre-operatory chemotherapy or chemo-radiation to increase short term survival.