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Cranial vena cava syndrome

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Abstract

Cranial vena cava syndrome is an uncommon but easily recognized sequela to obstruction of the cranial vena cava. Clinical signs are characteristic-symmetric, nonpainful, pitting edema of the head, neck, and forelimbs. Causes include thrombosis of the vessel along with compression or invasion by tumors and granulomas. Evaluation typically includes thoracic imaging and tissue sampling of masses for cytologic or histologic diagnosis. Treatment is aimed at correcting the underlying process; however, endovascular therapies currently used in human medicine may apply to veterinary patients. The prognosis reflects the underlying etiology and is therefore generally guarded.

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... The end result is subcutaneous, pitting edema of the head, neck, and forelimbs, giving rise to the classic clinical presentation of cranial vena cava syndrome. 27 In addition to edema, jugular venous distention and engorgement of conjunctival and scleral vessels may occur. Pleural effusion is frequently part of the clinical picture and tends to be chylous in nature. ...
... Pleural effusion is frequently part of the clinical picture and tends to be chylous in nature. 18,26,27,29 This clinical presentation should be differentiated from that associated with obstruction or compression of the caudal vena cava. Clinical signs associated with caudal vena cava syndrome include ascites, subcutaneous edema that extends along the dependent parts of the abdomen and hind limbs, and in some cases, hepatomegaly. ...
... 12 Mediastinal neoplasia is one of the most common causes of this syndrome reported in veterinary medicine. 27 Thymoma is the most common neoplasm reported in veterinary patients with cranial vena cava syndrome. 8,27 Other neoplasms have also been reported, including mediastinal lymphoma, carcinoma, and aortic body tumors. ...
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... Differential diagnoses for cranial vena cava syndrome in cats and dogs include mediastinal neoplasia, mediastinal fungal granuloma, and cranial vena cava thrombosis (i.e., secondary to hyperocagulable states, tumor emboli, jugular catheters). Although not reported in small animals, ectopic parathyroid tissue, and mediastinal abscess have been suggested as possible differentials for cranial vena cava syndrome (11). ...
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