Background A previously well 15-year-old girl presented with a 2-month history of facial swelling that progressively worsened to involve the neck. There was associated dyspnoea, orthopnoea, headache and throat discomfort. Two weeks before presentation, the patient had an episode of fever for 5 days. On examination, vital signs were within normal limits. Swelling, plethora and venous distension of the face and neck were apparent (figure 1).
What is the most likely diagnosis?
Superior vena cava syndrome
Describe the chest X-ray (figure 2).
What are the acute concerns?
What investigations would you order?
Questions Answers can be found on page 02.
- adolescent health
- paediatric practice
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Contributors Conceptualisation and design of the study: WSL and SHG. Drafting the manuscript: WSL and SHG. Revising the manuscript: WSL, SHG, MSFS, KWY, CTJ.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.