Episode 012: Heme/Onc Emergencies, Pt. 1: SVC Syndrome
Listen to this episode from The Fellow on Call: The Heme/Onc Podcast on Spotify. Emergencies happen in hematology and oncology. This is a fact. But how do we manage these emergencies? Look no further. In this episode, we talk all about first oncologic emergencies: superior vena cava (SVC) syndrome.Superior vena cava syndrome: Important: although we focus on a possible malignant mass in this discussion about SVC, other things can also cause SVC syndrome. How do you know about the chronicity of someone’s possible SVC syndrome? Compare to a recent picture!Image of patient with collateralization with SVC syndrome: DOI: 10.1056/NEJMicm1311911Workup: Need to determine the etiology; imaging is important: CT of chest (CT venogram)Consider ultrasound to rule out thrombosis Get biopsy (eventually) if this is malignancy DDx of mediastinal masses: 5Ts:ThymomaTerrible lymphoma (B or T-cell)Testicular cancerTeratoma Thyroid malignancies Central line (causing occlusion) +/- clotSo now what? Yes, an a