SURGICAL REVERSAL OF SUPERIOR VENA CAVA SYNDROME: Report of Case Caused by Intrathoracic Goiter and Associated with Roentgenographic Hilar Vascular Shadow Simulating Neoplasm of Chest

SINCE William Hunter, in 1757, described a case of obstruction of the superior vena cava, many other cases have been reported in the world literature. Although the syndrome produced by such obstruction is relatively constant, the obstruction itself may result from many different primary diseases. Ehrlich, Ballon, and Graham¹ reviewed the world literature to 1933 on this subject and reported 309 cases. In their series, the etiologic agent in 35% of cases was aortic aneurysm, with or without arteriovenous fistula; in 50%, thoracic neoplasms, primary and secondary, and in 15%, rarer causes. In 1949, McIntire and Sykes² reviewed 219 cases and found the etiologic factor to be aortic aneurysm in 26.9%, primary and secondary thoracic neoplasms in 33%, chronic mediastinitis in 20.7%, and miscellaneous factors in 19.4%. Glushien and Mansuy³ as well as Rose⁴ have stressed the poor prognosis in vena caval obstructions, and the former