1. Superior Vena Cava Syndrome Which Causes Gross Mass During Pregnancy Multidisciplinary Approach
Ali Akdemir1, Çağdaş Şahin1, Seda Akgün1, Önder Kavurmacı2, Ayşe Gül Ergönül2, Ufuk Çağırıcı2, Münevver Erdinç3 1Ege University Faculty Of Medicine, Obstetrics and Gynecology Department, İzmir 2Ege University Faculty Of Medicine, Thoracic Surgery Department, İzmir 3Ege University Faculty Of Medicine, Chest Diseases Department, İzmir

2. Superior Vena Cava Middle mediastinum right and left innominate veins
right atrium
6-8 cm

3. Causes of SVCS Malignancy (80-90 %) Beingn (10-20 %)
Bronchogenic carcinoma
Metastatic pulmonary malignancy
Metastatic mediastinal malignancy
Lymphoma
Leukaemia
Beingn (10-20 %)

4. Presenting Signs And Symptoms
Facial edema 82%
Distanted neckveins
Facial plethora
Dyspnea
Cough
Hoarseness

5. Cases 32 years 26-27 weeks of pregnancy Additional diseases Ø
3 months ago
progressive dyspnea and
neck swelling

6. Imaging Thyroid ultrasound Echocardiography Magnetic resonance imaging
11X10 cm size mass
SVCS
Obstetric ultrasound

7. MRI

8. MRI

9. Diagnostic Procedures
transthoracic biopsy
open biopsy under local anesthesia
CD20 + diffuse large B-cell lymphoma

10. Treatment CHEMOTHERAPY pregnancy medicines timing ethic termination
emergency
information

11. Surveillance Pulse steroid Betamethasone Arterial blood gas
Biochemical parameters
NST, ultrasound

12. Immediate Chemotherapy
Rituximab
Etoposide phosphate
Prednisone
Vincristine sulfate (Oncovin)
Cyclophosphamide
Doxorubicin Hydrochloride

13. Perinatology Committee
Termination of pregnancy before 2. cure chemotherapy (35+0)
34+6
Water breaking
Cervical dilatation

14. C/S , 2220 gr , baby boy , vertex
the baby did not require neonatal intensive care
lactation inhibition

15. 2. cure R-EPOCH
MRI
Proliferation index 99%
3.-4. cure R-DHAP
(Rituximab–Dexamethasone–Cytarabine– Cisplatin)

16. Discussion Physiological ? Pathology? Imaging Diagnosis Surveillance
Treatment
Side effects