Superior vena cava syndrome caused by colon adenocarcinoma metastasis: a case report and review of literature.

Superior vena cava (SVC) syndrome is a critical medical condition that usually results from compression of the SVC by an intrathoracic mass. The majority of contemporary etiology of SVC syndrome are related to mediastinal malignancies and/or to the presence of intravascular devices. Rarely, SVC syndrome has been associated with intraluminal metastasis to this vessel. We describe an unusual case of an 88-year-old woman with stage IIA colon carcinoma diagnosed seven years earlier that was treated with surgical resection, who presented with classical signs and symptoms of SVC syndrome. Imaging studies confirmed the presence of an extensive mass in the SVC and intravascular biopsies showed metastatic colon cancer. She was treated with palliative radiotherapy with good clinical response, remaining asymptomatic eight months after the documentation of metastatic disease. To our knowledge this is the second published case of colorectal adenocarcinoma with intravascular metastasis to the superior vena cava causing SVC syndrome. We discuss the different etiologies and management of this syndrome, and encourage physicians to consider intraluminal metastasis as one of the etiologies.