They usually have a long asymptomatic course and represent 60-70% of all GCTs occurring in mediastinum.4 Anterior mediastinal teratomas are rare, slow growing, usually 1/3 of patients are asymptomatic,4 diagnosed incidentally by chest radiographs.2 We report an unusual case of anterior mediastinal teratoma in a young lady disguised as a neck swelling with significant tracheal compression and mild SVC obstruction
was present in 2 patients (6.4%), while CNS metastasis was seen in 3 patients (9.6%).
An arm venogram confirmed SVC obstruction
, with severe stenosis at the right subclavian vein and partial obstruction of left subclavian vein with multiple collaterals.
One patient developed mild SVC obstruction
having 6mmHg gradient and is doing well on follow up since 9 months.
Quick symptomatic relief can be provided by balloon angioplasty with stenting and that is why it is often considered as a first-line therapy in thrombotic SVC obstruction
[sup] For example, the azygos vein would act as the bypass collateral to the right atrium during the insertion under the condition that SVC obstruction
lies below the azygos vein.
Other benign processes such as central venous catheter and fibrosing mediastinitis can cause SVC obstruction
. Collateral venous channels are usually formed to restore venous return [1-4].
Though desirable in cases of benign SVC obstruction
, it is not always required in malignant stenoses, but may be necessary for total obstructions.
But age of the patient, smoking history, mediastina symptoms like hoarseness of voice, SVC obstruction
and dysphagia etc will favour lung cancer, said Professor (Dr) Rajendra Prasad.
Thyroid cancer can cause intraluminal SVC obstruction
from venous metastases.
of Patients Percentage (%) Cough 219 74.24% Chest pain 197 66.78% Dyspnoea 165 55.93% Haemoptysis 146 49.49% Decreased appetite 106 35.93% and weight loss Fever 82 27.80% Hoarseness of voice 58 19.66% SVC obstruction
32 10.85% Weakness 28 9.49% Headache and/or convulsion 10 3.39% Dysphagia 6 2.03% Horner's syndrome 4 1.35% Table 3.
of Patients (n = 93) Percentage Cough 70 75.26% Dyspnea 53 56.98% Chest pain 44 47.31% Hemoptysis 42 45.16% Fever 36 38.70% Hoarseness of voice 17 18.27% SVC Obstruction
9 9.67% Table 5: Site of involvement Site No.