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Superior vena caval obstruction: a rare presentation of Behcet’s disease
  1. Avinash Anil Nair1,
  2. D J Christopher2,
  3. Fazil Moidu3 and
  4. Divya Chandran3
  1. 1Respiratory Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
  2. 2Pulmonary Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
  3. 3Radiology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
  1. Correspondence to Dr Avinash Anil Nair; avinash444{at}hotmail.com

Abstract

A 25-year-old Indian man presented with low-grade fever followed by gradually increasing swelling of neck and face. Physical examination showed bilateral neck swelling, facial swelling and dilated veins in the upper chest. Superior vena cava (SVC) obstruction due to an underlying malignancy was suspected. CT thorax showed large saccular aneurysm with thrombosis of bilateral subclavian arteries of which the right one caused external compression of right innominate vein draining into the SVC. A history of recurrent oral and scrotal ulcers was obtained following which skin pathergy test was done, which was suggestive of a diagnosis of Behcet’s disease (BD). He responded to treatment with steroids and azathioprine. This report illustrates that rare nonmalignant cause such as BD could also present with SVC obstruction.

  • connective tissue disease
  • vasculitis
  • respiratory medicine
  • lung cancer (oncology)
  • interventional radiology

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Footnotes

  • Twitter @avinash444@hotmail.com

  • Contributors AAN has substantial contributions to the conception and design of the work. DJC edited the draft of work and final approval of the version published. FM reported all the images and provided valuable insights into radiological diagnosis of this condition. DC has given significant contribution to literature search and manuscript preparation and editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.