RESUMO
An adult woman with a prior history of treated non-Hodgkin's lymphoma presented for screening mammography, which incidentally demonstrated dilated veins throughout the bilateral breasts. Concern for a superior vena cava stenosis or obstruction was raised despite the patient being asymptomatic; the patient underwent further imaging with chest CT, which revealed focal stenosis of the superior vena cava, attributed to fibrosis secondary to prior radiation therapy. Superior vena cava syndrome (SVCS), the spectrum of disease caused by superior vena cava narrowing or obstruction, requires prompt investigation given its association with intrathoracic malignancy, primary lung cancer and poor outcomes. This report explores the benign and malignant causes, signs and symptoms, preferred investigations, and treatment of SVCS. This case highlights the potential importance of screening mammography in revealing unexpected ancillary diagnoses, especially in high-risk patients.
Assuntos
Achados Incidentais , Mamografia , Síndrome da Veia Cava Superior , Humanos , Feminino , Mamografia/métodos , Síndrome da Veia Cava Superior/diagnóstico por imagem , Síndrome da Veia Cava Superior/etiologia , Tomografia Computadorizada por Raios X , Pessoa de Meia-Idade , Neoplasias da Mama/diagnóstico por imagem , Linfoma não Hodgkin/diagnóstico por imagem , Veia Cava Superior/diagnóstico por imagemRESUMO
Breast cancer screening guidelines vary for women at intermediate risk (15%-20% lifetime risk) for developing breast cancer across jurisdictions. Currently available risk assessment models have differing strengths and weaknesses, creating difficulty and ambiguity in selecting the most appropriate model to utilize. Clarifying which model to utilize in individual circumstances may help determine the best screening guidelines to use for each individual.