HIV complicates the management of oncological emergencies: A case involving the superior vena cava syndrome

An association exists between human immunodeficiency virus (HIV) and an inc reased incidence of lung cancer. Superior vena cava syndrome (SVCS) is an o ncological emergency seen in the presence of chest tumours. We report on an otherwise well HIV-positive male who presented with SVCS due to lung cance r. He was commenced on dexamethasone and radiotherapy with curative intent. Treatment was complicated by accelerated steroid- and radiation-induced mo rbidity. The patient died of disseminated aspergillosis after receiving 27 of 35 planned radiotherapy fractions. The management of SVCS in those with HIV is challenging and requires the judicious use of steroids, antifungal p rophylaxis and palliative radiotherapy doses.