Mass lesions associated with the superior mediastinum syndrome include:
(1) substernal thyroid goitre or tumor
(2) thymoma
(3) malignant lymphoma
(4) other primary or metastatic carcinomas
(5) tuberculosis or deep fungal infection
Manifestations of the superior mediastinal syndrome:
(1) findings of the superior vena cava syndrome (see below)
(2) tracheal obstruction
(3) variable esophageal obstruction
Clinical findings of the superior vena cava syndrome include:
(1) congestion and cyanosis of the head, neck and upper extremities, with no congestion in the abdomen, pelvis or lower extremities
(2) swelling with a feeling of fullness of the head, neck and upper extremities with no swelling in the lower extremities
(3) cerebral symptoms (associated with venous hypertension
(4) cervical venous distention
The patient is at increased risk for cardiopulmonary arrest if they are administered a sedative or anesthetic agent.
