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Cancer
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Elyce Cardonick, Charlotte Maggen, Puja Patel
Non-Hodgkin's lymphoma (NHL) is rarely reported during pregnancy as this generally occurs in an older age group (mean age at diagnosis is 42 years). NHL refers to a group of lymphoproliferative diseases (ranging from indolent to aggressive) among which, diffuse large B cell lymphoma is the most commonly reported, and often diagnosed at advanced stages [66]. Pregnant women present with an aggressive histology, but the response to treatment, failure, and progression rates are reported to be similar to non-pregnant patients [66–68]. Women with NHL in one study was shown to be at an increased risk for pre-eclampsia, cesarean-section, preterm births, and postpartum blood transfusions [69]. Symptoms can vary widely, with many complaints and presentations such as ovarian masses can be similar to symptoms in normal pregnancy, which can lead to a delay in diagnosis of NHL in pregnancy. Superior vena cava syndrome can occur in which the patient will complain of swelling in upper extremity and face after a long duration of elevation of the arms.
Mediastinal goiters
Published in Demetrius Pertsemlidis, William B. Inabnet III, Michel Gagner, Endocrine Surgery, 2017
Yamil Castillo Beauchamp, Ashok R. Shaha
Obstruction of venous return occurs in less than 10% of cases. It may be minimal but can be demonstrated by elevating the patient’s arms (Pemberton’s sign) and observing the distention of neck veins. The symptoms and signs may become more severe as the intrathoracic mass becomes larger, progressing to a full-blown superior vena cava syndrome with dilatation of the veins of the neck, face, and descending collateral venous circulation, as well as cyanosis. Other rare symptoms may be related to compression of the mediastinal vessels, such as downward esophageal varices, Horner’s syndrome, pleural effusion, and transient ischemic attacks secondary to the goiter stealing the blood from cerebral circulation [20–26]. Although rare, the appearance of symptoms of venous obstruction is an urgent indication for surgery. The obstruction may be due to the encroaching bulk of a benign nodular goiter or the result of malignant infiltration.
Clinical applications of hyperthermia in cancer treatments
Published in Clifford L. K. Pang, Kaiman Lee, Hyperthermia in Oncology, 2015
Clifford L. K. Pang, Kaiman Lee
Superior vena cava syndrome is a life-threatening acute syndrome in the medical oncology. It is common clinically and caused by influences that block blood partially or completely when it flows back to the right atrium from the superior vena cava. It can cause patients to suffer from acute or subacute dyspnea and swelling of face and neck. Through clinical examinations, the venous returns of face, neck, upper limbs, and thorax are blocked, showing blood stasis and edema, the further progress of which can cause oxygen deficit and rise of intracranial pressure. A rapid radiotherapy should be applied, especially to the small-cell carcinoma of the lung; radiation therapy is a key therapeutic method. The therapy for the superior vena cava syndrome aims to not only relieve the symptom, but also cure the primary tumor as far as possible. It is for patients with wide metastasis who require an immediate effect, and chemotherapy is more advisable than radiotherapy. The patient must restrict the intake of sodium salt and liquid. The diuretics show sound effect on relieving the edemas on neck, face, and upper limbs, while the oxygen-absorbing remission can cause dyspnea. In addition, the glucocorticoid hormone can relieve any inflammatory reaction caused by edema around tumor and radiotherapy.
Major vessel invasion by thyroid cancer: a comprehensive review
Published in Expert Review of Anticancer Therapy, 2019
Michael S. Xu, Jennifer Li, Sam M. Wiseman
A small number of patients may also present with signs and symptoms of superior vena cava syndrome (SVCS). SVCS may occur due to either external compression caused by a retrosternal cancer and/or a metastatic lymph node mass, or due to direct intravascular extension of a tumor thrombus into the SVC [4]. In addition to the classic triad of venous dilation/distension, facial edema, and dyspnea, patients diagnosed with SVCS may also present with a Pemberton’s sign (evidenced by facial plethora or cyanosis upon simultaneous elevation of both arms), upper extremity edema, and dilated chest wall collateral veins [49–53]. In the most extreme presentation, sudden death may occur due to massive pulmonary tumor embolism or right atrium obstruction [51–53]. In the literature, there have been 31 reported cases of thyroid cancer invading the SVC, and SVCS was diagnosed in 20 (65%) of these cases. One epidemiological study reported that the clinical incidence of SVC obstruction by thyroid cancer was 0.8%, with the predominant cancer type being either PDTC or ATC [54]. In several of these reported cases, the presentation of distended neck veins was the only clinically identifiable evidence of an underlying thyroid malignancy. Nonetheless, the absence of clinical evidence of SVCS does not preclude the possibility of cancer involving the SVC, given that the 11 remaining cases with SVC involvement were asymptomatic until identified by subsequent imaging [50,55–61].
Primary Mediastinal Germ Cell Tumors (PMGCT): A Real-world Analysis From A Tertiary Cancer Care Center in India
Published in Cancer Investigation, 2023
Aparna Sharma, Rohit Reddy, Raja Pramanik, Ranjit Kumar Sahoo, Seema Kaushal, K.P. Haresh, Sunil Kumar, Lalit Kumar, Atul Sharma, Atul Batra
The most common symptoms reported by patients with PMGCT were cough and dyspnea. PMGCT can present as superior vena cava obstruction (SVCO) in 10–28% of patients with PMGCT, which is an oncological emergency (13). In our study, four (13%) patients presented with superior vena cava syndrome. A high degree of suspicion must be kept in young males presenting with a mediastinal mass with or without SVCO.