SUPERIOR VENA-CAVA SYNDROME AND TRACHEAL OBSTRUCTION DUE TO MULTINODULAR GOITER

Tracheal obstruction and superior vena cava (SVC) syndrome are rare co mplications of retrosternal goiter. These two conditions present a dif ficult diagnostic and therapeutic challenge. Malignancy is the most co mmon cause of SVC syndrome. Determining whether SVC syndrome is due to a benign or malignant process is imperative before instituting treatm ent, but this determination may be difficult. We present a case of a p atient presenting with upper airway obstruction and SVC syndrome with a large mediastinal mass. The mass was determined to be a multinodular goiter. The patient was managed by surgical removal of the goiter wit h complete resolution of symptoms. This case illustrates the need for careful preoperative evaluation and the importance of establishing a h istologic diagnosis prior to initiating treatment for SVC syndrome. (C ) 1994 John Wiley & Sons, Inc.