Superior vena caval obstruction is it a medical emergency?

Superior Vena Caval Obstruction: King Khalid University Hospital Experience

“…The distribution of etiologies of superior vena caval obstruction in this study, particularly a malignant to benign ratio of 4.25 to 1, is similar to other studies [3][4][5][6][7]11,13] in the literature reported from general hospital populations. In our experience, the underlying malignant disorder was found to be lymphoma (33%), small cell lung cancer (10%), and non-small cell cancer (24%).…”

“…This could be attributed to the higher relative frequency of lymphomas among Saudi patients, as has been shown in many published epidemiological studies [14][15][16] about cancer in Saudi Arabia. All benign underlying disorders of SVCO in our report have been reported in previous reports [11,17].…”

“…As shown in our experience, and that of others [3,11], it takes a longer time to seek medical advice in benign diseases and this may reflect a rate of occlusion of the vein more rapidly in malignant diseases in comparison with gradual fibrotic compression in benign conditions. Also, the time taken to arrive at a tissue diagnosis correlated with benign causes, a finding which probably follows from the relative ease with which carcinoma is diagnosed as compared with benign disease is frequently a diagnosis made by exclusion.…”

“…The lymphoma percentage among the malignant underlying causes of SVCO was higher than what has been reported in many Western studies [11,13] where bronchogenic carcinoma accounts for approximately 80% of cases. Lymphoma was found in only 8% to 12% of malignant underlying disorders.…”

“…The conventional emergency treatment for SVC obstruction has been radiation therapy, often started prior to the establishment of a definitive histological diagnosis [9,13,[18][19][20], but the current opposing views [8,11,21] do not agree with this approach. Accurate histological diagnosis may be difficult after the initiation of radiotherapy treatment.…”