26th February 2025

A 56-year-old man has a background of hypertension, borderline diabetes and metastatic small cell lung cancer

A 56-year-old man has a background of hypertension, borderline diabetes and metastatic small cell lung cancer. He is due to commence treatment with chemotherapy in one week’s time. He attends the A&E department complaining of breathlessness.

On examination, his observations are as follows: heart rate 112 bpm, blood pressure 128/73 mmHg, respiratory rate 22, oxygen saturation 97% on room air, temperature 36.7 degrees Celsius. You notice he has facial redness with some venous distension on his upper chest and neck.

A contrast CT scan of his thorax reveals a large left lung upper lobe mass that is causing compression of his superior vena cava.

What would be your first step in the management of this patient?

Select the SINGLE most appropriate option from the list below. Select ONE option only.