30th December 2024

Investigations in SVCO

Eighty percent of patients with SVCO have an abnormal CXR. Findings include mediastinal widening (right-sided paratracheal mass or mediastinal lymphadenopathy) or other features of lung cancer, e.g. unilateral effusion.

CT thorax with contrast is important to delineate the cause and may also help evaluate underlying malignancy. If no mass is identified, a venogram will identify any thrombus and allow planning for thrombolysis or stent insertion.

Up to 50-60% of patients presenting with malignant SVCO do not have a prior diagnosis of cancer. In these cases, urgent investigations will need to be completed to diagnose the primary cancer (further imaging and biopsy).