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Primary mediastinal T-ALL presenting with superior vena cava syndrome
  1. Alison Gibbons,
  2. Emmanuel Tito,
  3. Justin Baik and
  4. Ines Kafando
  1. Johns Hopkins School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to Ms Alison Gibbons; agibbon7{at}jhmi.edu

Abstract

Superior vena cava syndrome (SVCS) is a rare but serious condition typically associated with malignancy. While lung cancer and lymphoma are common causes, less frequent aetiologies can present a diagnostic challenge. We report a case of a young adult female who presented with classical symptoms of SVCS, including facial oedema, neck vein distention and dyspnoea. Diagnostic workup revealed a large mediastinal mass, which was subsequently confirmed as T cell acute lymphoblastic leukaemia (T-ALL) on biopsy. This case highlights the importance of considering T-ALL in the differential diagnosis of SVCS, particularly in younger individuals without traditional risk factors. Early recognition and prompt initiation of appropriate therapy, including chemotherapy and potentially radiation therapy, are crucial for optimal patient outcomes. This case underscores the need for a high index of suspicion for rare malignancies, even in the context of common presentations.

  • Respiratory cancer
  • Haematology (incl blood transfusion)
  • Leukocytosis
  • Lung function

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: AG, ET, JB, IK. The following authors gave final approval of the manuscript: AG, ET, JB, IK. Guarantor is ET.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.