以皮肤弥漫性肿胀为首发表现的胸腔肿瘤致上腔静脉综合征1例  

Diffuse skin swelling as the initial presentation of superior vena cava syndrome caused by thoracic tumor: a case report

作　　者：李世洋 曹先伟[1] 万川 邓雪华 余晨[1] 吴红宣[1] 张志彬 LI Shiyang;CAO Xianwei;WAN Chuan;DENG Xuehua;YU Chen;WU Hongxuan;ZHANG Zhibin(First Affiliated Hospital of Nanchang University,Nanchang 330000,China)

机构地区：[1]南昌大学第一附属医院,江西南昌330000

出　　处：《皮肤性病诊疗学杂志》2023年第4期352-356,共5页Journal of Diagnosis and Therapy on Dermato-venereology

基　　金：江西省教育厅科学技术研究项目(GJJ200230);江西省卫健委科技计划项目(202110030)。

摘　　要：报告1例以皮肤弥漫性肿胀为首发表现的胸腔肿瘤致上腔静脉综合征。患者女,62岁,颜面部红斑、肿胀伴瘙痒6个月,加重5 d。皮肤科检查:颜面部见弥漫性水肿性红斑,边界不清,压之褪色,触之紧绷感,颈项部及双上肢肿胀,均为非凹陷性。外院诊断为过敏性皮炎,予抗过敏等对症治疗,瘙痒稍改善,颜面部红肿无明显改善,且逐渐加重。我院胸部多层螺旋CT示:纵膈、右肺门软组织肿块考虑为恶性病变,肿块累及上腔静脉、心房、右侧胸膜,并上腔静脉及分支、右心房、右上肺静脉、左心房癌栓形成。诊断:胸腔肿瘤致上腔静脉综合征。因考虑经济原因及手术风险,患者未在我院进一步治疗,目前已失访。We present a case of superior vena cava syndrome caused by thoracic tumor with initial presentation of diffuse skin swelling.A 62-year-old female presented with facial erythema,swelling and itching for 6 months,with aggravation for 5 days.Dermatological examination showed diffuse edematous erythema on the face,with unclear boundary,fading under pressure,tight feeling of touch,nonpitting edema of the neck and upper limbs.The patient was diagnosed as allergic dermatitis in other hospital.Following the treatments with antiallergic and other symptomatic treatment,pruritus was slightly improved,but the erythema and swelling of the face were not significantly improved,and gradually aggravated.Chest multislice helieal CT showed soft tissue masses on the mediastinum and right hilum.The lesions were considered as malignant lesions involved the superior vena cava,atrium and right pleura.Formation of tumor thrombus in superior vena cava and its branches,right atrium,right superior pulmonary vein and left atrium were also seen.Diagnosis:thoracic tumors complicated with superior vena cava syndrome.Due to the concerns of medical cost and surgical risks,the patient did not receive further treatment in our hospital and was lost to follow-up.

关 键 词：上腔静脉综合征 胸腔肿瘤 

分 类 号：R730.6[医药卫生—肿瘤]