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Vol.53 No.3 contents | Japanese/English |
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- Case Report -
Endovascular Stenting for Superior Vena Cava Syndrome Caused by a Malignant Pleural Mesothelioma
Seiji Nagashima1,2, Minoru Fukuda2, Takeshi Kitazaki2, Kazunori Mitarai3, Masakazu Mori3, Shigeru Kohno11Second Department of Internal Medicine, Nagasaki University Hospital, Japan, 2Department of Respiratory Medicine, 3Department of Radiology, Japanese Red Cross Nagasaki Genbaku Hospital, Japan
Background. Superior vena cava syndrome (SVCS) is a serious complication of cancer; however, intravenous stenting is infrequently performed as treatment for SVCS in Japan because the procedure has not been approved for coverage by the Japanese national health insurance program. Case Report. A 67-year-old male undergoing chemotherapy for malignant pleural mesothelioma developed dyspnea and was admitted to our hospital two years and two months after receiving the cancer diagnosis. On CT, the patient's right pleural lesion exhibited enlargement, causing stenosis of the SVC, right main pulmonary artery and right main bronchus. He presented with edema of the upper body, including the face, and cervical vein swelling, and SVCS was diagnosed. The dyspnea increased in severity in spite of a well-maintained SpO2 value, and the patient developed an urgent status; therefore, it became difficult to wait for the effects of radiotherapy. After obtaining informed consent from the patient and his family, SVC stenting was performed. The patient's symptoms immediately improved following treatment, and no complications were observed. The SVCS did not recur for three months, after which the patient moved into home medical care. Conclusion. Our results in this case show that SVC stenting is a useful therapeutic option for treating SVCS caused by malignant mesotheliomas. Furthermore, we expect that endovascular treatment for SVCS will be approved for coverage under the Japanese national health insurance program.
key words: Malignant pleural mesothelioma, Superior vena cava syndrome, Stenting
Received: October 19, 2012
Accepted: June 10, 2013
JJLC 53 (3): 250-254, 2013
