Facial Swelling

doi:10.1017/9781009500760.039

Chapter 39 - Facial Swelling

Published online by Cambridge University Press: 24 April 2026

Corey Coleman and

Moira Davenport

Edited by

Angela Bray Lindsay and

Monica Kathleen Wattana

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Angela Bray Lindsay: Affiliation:
Virginia Commonwealth University
Monica Kathleen Wattana: Affiliation:
University of Texas, MD Anderson Cancer Center

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Summary

1. Superior vena cava (SVC) syndrome should be suspected in patients with shortness of breath and swelling of the head and neck. As symptoms progress, arm swelling may develop and in severe cases, distension of neck and chest veins.

2. Once suspected, immediately raise the head of the patient’s bed to decrease hydrostatic pressure. Monitor the patient’s airway for laryngeal edema – patients may require intubation if they have respiratory compromise.

3. Ultrasound can be used to assess for evidence of thrombus. However, CT chest with contrast or MRI is the preferred modality of imaging.

4. If thrombus is suspected, the patient should be started on anticoagulation, typically heparin.

5. In cases where SVC syndrome is caused by tumor infiltration/compression, endovascular stenting has become the most popular method of alleviating the obstruction. Patients may also require tumor debulking with radiation therapy and/or chemotherapy.

Keywords

Superior vena cava syndrome Mediastinal mass Facial swelling Endovascular stenting Chemotherapy/radiation Oncologic Emergency Small cell lung cancer Lymphoma

Information

Type: Chapter
Information: Oncologic Emergency Medicine
Clinical Cases Illustrating Key Concepts
, pp. 208 - 211
DOI: https://doi.org/10.1017/9781009500760.039 [Opens in a new window]
Publisher: Cambridge University Press
Print publication year: 2026

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