Superior vena cava syndrome

Superior vena cava syndrome (SVCS) affects approximately 15,000 people annually in the United States. Currently, mediastinal malignancies, primarily small cell lung cancer, account for the majority of cases of SVCS. Iatrogenic causes, predominantly long-term central venous catheters, account for approximately 7% of cases of SVCS, and the incidence is increasing. Historically, SVCS was considered an oncologic emergency that required urgent treatment. It is now evident that SVCS is rarely a true emergency and that treatment may be safely provided in a deliberate fashion to the majority of patients. This article provides an overview of the etiology, presentation, diagnosis, and management of SVCS.