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Prostate Cancer Recurrence Manifesting as Superior Vena Cava Syndrome Pouyan Golshani, MD, Faramarz Edalat, MD, and Tarak H. Patel, MD An 85-year-old man with prostate cancer in remission for 13 years presented with a 6-month history of worsening dyspnea and facial edema. Computed tomography angiography demonstrated an enhancing mass within the left brachiocephalic vein and superior vena cava (SVC) (Fig 1). Hypermetabolic activity was demonstrated on fluorodeoxyglucose positron emission tomography (Fig 2) without other metastatic foci. Prostate-specific antigen was 57.6 ng/mL (normal

range, 0–4.0 ng/mL). SVC venography (Fig 3) and a clamshell biopsy were performed. Histology demonstrated tumor cells immunoreactive to NKX3.1 (Fig 4), protein, and prostate-specific acid phosphatase consistent with metastatic prostate adenocarcinoma. SVC syndrome as the presentation of prostate cancer recurrence is rare with only a single case previously reported. The patient was started on leuprolide and experienced symptomatic improvement.

Figure 2.

Figure 1.

Figure 3.

Figure 4.

From the Department of Interventional Radiology & Image Guided Medicine, Emory University School of Medicine, 1364 Clifton Road Northeast, Atlanta, GA 30309. Address correspondence to: P.G.; E-mail: [email protected]

& SIR, 2015

None of the authors have identified a conflict of interest.

http://dx.doi.org/10.1016/j.jvir.2015.01.012

J Vasc Interv Radiol 2015; 26:855

Prostate cancer recurrence manifesting as superior vena cava syndrome.

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