A 66-year-old man comes to the physician due to recent lethargy and weakness. He also states that has a headache and dyspnea. The patient's face has appeared swollen over the past 2 weeks. He does not have any neck or shoulder pain. He has no other medical problems. Physical examination shows symmetrical facial swelling and conjunctival edema. The pupils are equal, round, and reactive to light. An engorged veins on the anterior chest wall are noted over his neck and upper trunk. Heart and lung sounds are normal. Peripheral strength and sensation are intact. Which of the following is the most likely cause of this patient's condition?

Question

A 66-year-old man comes to the physician due to recent lethargy and weakness. He also states that has a headache and dyspnea.  The patient's face has appeared swollen over the past 2 weeks.  He does not have any neck or shoulder pain.  He has no other medical problems.  Physical examination shows symmetrical facial swelling and conjunctival edema.  The pupils are equal, round, and reactive to light.  An engorged veins on the anterior chest wall are noted over his neck and upper trunk.  Heart and lung sounds are normal.  Peripheral strength and sensation are intact.  Which of the following is the most likely cause of this patient's condition?

Quizplus · Accepted Answer

Eductional Objective: Extrinsic compression of the superior vena cava by a mediastinal mass (eg, malignancy) can cause superior vena cava syndrome, with impaired venous return from the upper body.  Signs and symptoms include facial swelling, distended collateral veins, headache, and dyspnea.

A 66-Year-Old Man Comes to the Physician Due to Recent