Bronchogenic carcinoma with superior vena caval invasion

Case contributed by Dr Ahmed Abdrabou


Dyspnea, cough and facial swelling

Patient Data

Age: 55
Gender: Male

Right upper lobe mass infiltrating the right brachiocephalic vein and superior part of SVC with development of posterior and anterior chest wall collaterals.

Right diaphragmatic paralysis likely due to phrenic nerve infiltration.

Right paratracheal lymphadenopathy.

Diagnosis: T4N1Mx

Case Discussion

  • most common malignancy in males.
  • age : > 50 years old.
  • sex : M>F.

TNM classification:

  • T1
    • T1a (< 2 cm),
    • T1b (2-3 cm) surrounded by lung or visceral pleura, without invasion more proximal than lobar bronchus.
  • T2
    • T2a (3-5 cm), T2b (5-7 cm), or tumor with any of the following features:
      • involves main bronchus > 2 cm distal to carina
      • invades visceral pleura
      • associated with atelectasis or obstructive pneumonitis that extends to the hilar region but does not involve the entire lung
  • T3
    • tumor > 7 cm or any of the following
    • directly invades any of the following: chest wall, diaphragm, phrenic nerve, mediastinal pleura, parietal pericardium, main bronchus < 2 cm from carina without involvement of the carina.
    • atelectasis or obstructive pneumonitis of the entire lung
    • separate tumor nodules in the same lobe
  • T4
    • tumor of any size that invades the mediastinum, heart, great vessels, trachea, recurrent laryngeal nerve, esophagus, vertebral body, carina, or with separate tumor nodules in ipsilateral lobe.


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Case information

rID: 22378
Published: 28th Mar 2013
Last edited: 16th Jul 2018
System: Chest, Oncology
Inclusion in quiz mode: Included

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