Endovascular Stenting for Malignant Superior Vena Cava Syndrome Complicated by Interstitial Pneumonia: A Report of 2 Cases

BACKGROUND Superior vena cava syndrome (SVCS) is a clinical condition most commonly caused by malignancy. Its management becomes challenging when complicated by interstitial pneumonia because radiotherapy carries a high risk of fatal adverse events. This report presents 2 cases of malignant SVCS complicated by interstitial pneumonia that were successfully managed with endovascular superior vena cava (SVC) stenting. CASE REPORT Case 1: A 68-year-old man with advanced small-cell lung cancer was admitted due to facial and bilateral upper-limb edema. He was diagnosed with SVCS caused by tumor compression based on contrast-enhanced computed tomography (CT). With a prognosis of surviving only a few months, and radiation therapy deemed difficult due to interstitial pneumonia, SVC stent placement was performed. After the procedure, the edema improved and he was discharged after 7 days. Case 2: A 75-year-old man with pulmonary squamous cell carcinoma was admitted due to facial and bilateral upper-limb edema, and dyspnea. A diagnosis of SVCS caused by tumor compression was established using contrast-enhanced CT. Based on a prognosis of surviving several months and interstitial pneumonia as a contraindication for radiation therapy, SVC stent placement was performed. The edema improved after the procedure and he was discharged 7 days later. CONCLUSIONS Stenting can be a useful indication for malignant SVCS, even in cases complicated by interstitial pneumonia. SVC stenting offers a fast and safe treatment option, quickly improving symptoms and quality of life, and allowing for early patient discharge.