Abstract
Background: Superior vena cava (SVC) syndrome may result from extravascular compression or intravascular obstruction such as thrombosis. Recurrent venous thrombosis is typically associated with a hypercoagulable state such as malignancy, and inheritable or acquired coagulopathy. Sarcoidosis is a derangement of the immune system, and it has been associated with malignant diseases and hypercoagulation. The association of pancreatic cancer and sarcoidosis with SVC syndrome has not been reported previously. Here, we present a case of recurrent venous thrombosis causing SVC syndrome in a patient with pancreatic ductal adenocarcinoma and underlying thoracic sarcoidosis. Methods: The patient’s electronic health record was retrospectively analyzed. Results: A 66-year-old woman with pancreatic adenocarcinoma was treated with neoadjuvant chemotherapy followed by Whipple procedure, before developing tumor recurrence in the liver. Her treatment course was complicated with repeated incidents of venous thrombosis in the presence of a central venous catheter leading to recurrent SVC syndrome, which resolved with anti-coagulation. Conclusions: This case raises a plausible inter-relationship between sarcoidosis, pancreatic cancer, and hypercoagulable state. We suggest that patients with multiple risk factors for developing venous thrombosis should be carefully monitored for any thrombotic event, and they may benefit from prophylactic anti-coagulation.
Highlights
Superior vena cava (SVC) syndrome is a medical emergency that comprises a group of symptoms caused by obstruction of the SVC
A patient with a history of thoracic sarcoidosis was diagnosed with pancreatic adenocarcinoma, who developed recurrent venous thrombosis causing SVC syndrome in the pancreatic adenocarcinoma, who developed recurrent venous thrombosis causing SVC syndrome in presence of indwelling venous catheters
This case report adds to the rare association of pancreatic adenocarcinoma to our knowledge, this represents the first reported case of SVC syndrome caused by venous thrombosis with sarcoidosis
Summary
Superior vena cava (SVC) syndrome is a medical emergency that comprises a group of symptoms caused by obstruction of the SVC. Several cases of SVC syndrome have been reported as a rare manifestation of sarcoidosis, in which the thoracic granuloma causes compression of the SVC [3,4,5,6,7]. Superior vena cava (SVC) syndrome may result from extravascular compression or intravascular obstruction such as thrombosis. Recurrent venous thrombosis is typically associated with a hypercoagulable state such as malignancy, and inheritable or acquired coagulopathy. The association of pancreatic cancer and sarcoidosis with SVC syndrome has not been reported previously. We present a case of recurrent venous thrombosis causing SVC syndrome in a patient with pancreatic ductal adenocarcinoma and underlying thoracic sarcoidosis. Methods: The patient’s electronic health record was retrospectively analyzed
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