FACE AND TRUNK EDEMA IN ONCOLOGY ; ALWAYS PERFORM AN CHEST CT SCAN

Spontaneous secondary pneumothorax occurs in patients with known pulmonary pathology. It requires a fast and adequate care because can engage the prognosis. (1)different therapeutic approaches are used for the management of pneumothorax: exsufflation, chest drainage and other more invasive methods. (2) We report the case of a patient followed for pulmonary neoplasia, treated for a vena cava syndrom without any imaging and which returned 2 weeks later with an aggravation of his edema and respiratory state because of a bilateral unknown pneumothorax. inlitteraure we find that , most SVC syndromes are associated with advanced malignant diseases that cause invasion of the venous intima or an extrinsic mass effect. Lung, breast and mediastinal neoplasms are common causes of SVC syndrome. SVC syndrome can lead to the formation of pleural effusion . Numerous case reports have described pleural effusions in conjunction with the SVC syndrome. These effusions occur in 60% of SVC syndrome cases (3) We didn?t found much informations about pneumothorax complicating the SVC syndrome , especially in lung neoplasia. Treatment of SVC syndrome is divided into supportive and definitive therapy. An obvious therapeutic manoeuvre is to elevate the patient?s head to decrease the hydrostatic pressure and thereby the edema. There are no data documenting the effectiveness of this manoeuvre, but it is simple and without risk. Glucocorticoid therapy (dexamethasone, 4 mg every 6 h) is commonly prescribed. There are different therapeutic approaches for the management of pneumothorax: manual exsufflation, conventional chest drainage and other more invasive methods. Our patient was treated for vena cava syndrome, without any imaging at first , hence the interest of this work . Thoracic CT scan allows diagnosis and the treatment remains controversial mainly by thoracic drainage. prognosis in patients with non-small cell lung cancer. Many clinical trials show no significant difference in the rate of relief from the SVC syndrome whether chemotherapy, radiotherapy, or chemotherapy with radiotherapy was used.