The inferior vena cava (IVC) syndrome as the initial manifestation of newly diagnosed gastric adenocarcinoma: a case report

Journal of Medical Case Reports

Shyam A. Patel¹ 

[1] Department of Medicine, Stanford Hospital and Clinics, Stanford University School of Medicine, 300 Pasteur Drive, Stanford 94305, CA, USA

关键词: Superior vena cava;    Secondary prevention;    Paraneoplastic syndrome;    Inferior vena cava;    Hepatic metastasis;    Gastric adenocarcinoma;   

Others  :  1233310
DOI  :  10.1186/s13256-015-0696-3

 received in 2015-02-07, accepted in 2015-08-26,  发布年份 2015

【 摘 要 】

Introduction

Vena cava compression is a relatively rare initial manifestation of underlying malignancy. The superior vena cava syndrome, which is characterized by facial plethora, jugular venous distension, and arm swelling, is a well-known entity associated with bronchogenic carcinoma. Less common is the compression of the inferior vena cava. To the best of my knowledge, this is the first reported case of newly diagnosed gastric adenocarcinoma presenting initially as the inferior vena cava syndrome. The unique aspect about this case is that it highlights a rare presentation before diagnosis of gastric adenocarcinoma.

Case presentation

A 56-year-old Malaysian woman with a past medical history of iron deficiency anemia presentedwith lower extremity edema and progressive fatigue of 1 month’s duration. She had significant worsening of leg swelling after standing for short periods of time. She also reported epigastric discomfort, which led to an additional workup, including computed tomography of the abdomen and pelvis. This revealed a 3cm×2.9cm mass in the stomach, extensive hepatic metastasis, and severe inferior vena cava compression. The patient was examined further with esophagogastroduodenoscopy, and a biopsy showed gastric adenocarcinoma.

Conclusions

This report describes a case of a patient with inferior vena cava syndrome as a unique presentation of previously undiagnosed stage IV gastric adenocarcinoma. Patients presenting with inferior vena cava syndrome should undergo prompt evaluation for underlying malignancies that have a predilection for hepatic metastasis. This case is important because earlier recognition of this syndrome can lead to earlier workup and thus detection of malignancy. Prompt initiation of treatment, including chemotherapy or vena cava stent placement, can result in improved patient outcome.

【 授权许可】

   
2015 Patel.

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