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A 75-year-old man with a substantial smoking history and stage IV non–small-cell carcinoma of the lung presented with progressive symptoms of cough, hoarseness, and swelling of the face and arms. On examination, he appeared plethoric, with a ruddy complexion, suffusion, pitting edema of the face and upper torso, and prominent spidery telangiectasia on his face and chest (Panel A). The jugular veins were nonpulsatile and distended. Contrast-enhanced computed tomographic imaging of the chest revealed a markedly compressed superior vena cava (SVC). An invasive venogram confirmed this finding and demonstrated severe compression of both the right and left subclavian veins (RSV . . . [Full Text of this Article] |
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