Abstract
The survival period following obstruction of the superior vena cava depends to some extent on the underlying cause of the obstruction—a benign lesion of gradual onset would be expected to result in the longest survival. While obstruction of the superior vena cava due to tumor or aneurysm is not uncommon, accounting for 70% to 85% of the cases, benign lesions causing obstruction of this vessel, such as mediastinitis and thrombophlebitis, are relatively uncommon.<sup>1</sup>The present case is reported because of the following points of interest: (1) gradual onset of signs and symptoms during and after a period of recurrent severe infections of the chest wall, strongly suggesting thrombophlebitis as the cause, (2) involvement of the azygos vein, as proved by angiograms and clinical tests (described elsewhere<sup>2</sup>), (3) prolonged survival period of 25 years, indicating adequate compensatory collateral circulation, and (4) minimal symptoms after 25 years, the diagnosis having
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