Hilar Mass with Venous Encroachment

A 56-year-old man, who had a history of cigarette smoking, noticed a sudden swelling in his neck, mainly on the right side. Shortly thereafter, his right arm became enlarged.

The patient complained of an uncomfortable sensation of fullness in his head and neck, but no real pain. Superior vena cava syndrome was suspected. A chest film demonstrated a hilar mass, and a CT scan showed venous encroachment with associated thrombus.

This patient had some relief of symptoms with radiotherapy and concomitant heparin, then coumadin, therapy. He died 5 months later from his cancer.