부산대학교 도서관

Superior vena cava syndrome, which comprises a group of nonspecific signs and symptoms caused by obstruction of the superior vena cava (SVC), is usually a complication of SVC compression by pulmonary or mediastinal tumors. Usual manifestations including shortness of breath, dyspnea, headache, and facial edema occur only after days to weeks after the beginning of SVC obstruction. Although a detailed medical history and physical examination may shed light on the diagnosis, imaging studies are usually required for establishing the diagnosis and pinpointing the causes. Herein, we report a case of facial edema resulting from obstruction of superior vena cava caused by right atrial carcinosarcoma with initial presentation mimicking anaphylaxis in the emergency department. Final diagnosis was made one month later after disease progression. The patient died of distant brain metastasis six months later despite aggressive treatment. For early diagnosis, emergency physician should have a high level of suspicion for non-specific symptoms hinting the diagnosis. Chest x-ray and contrast-enhanced chest computed tomography should be considered for differential diagnosis.