Symptoms - Face and Neck Swelling

Reviewed by: HU Medical Review Board | Last reviewed: January 2017.

Lung cancer can cause a symptom of swelling in the face and neck when a tumor (malignancy) presses on the vein from the head to the heart. This symptom is called superior vena cava syndrome or superior vena cava obstruction.

What causes a swollen face or neck in lung cancer patients?

The superior vena cava is the vein that carries blood from the head and arms back to the heart. It passes near the upper part of the right lung, as well as near lymph nodes in the chest cavity.

Tumors in or around the lung or in lymph nodes may interfere with the superior vena cava's function, blocking the normal flow of blood.1,2

The causes of superior vena cava obstruction

Superior vena cava obstruction is most often caused by cancer. In addition to lung cancer, other cancers that may cause superior vena cava obstruction include: breast cancer, lymphoma, testicular cancer, thyroid cancer, and a thymus tumor.

Other noncancerous conditions such as lung infections like tuberculosis, inflammation of a vein (thrombophlebitis), a fungal infection like histoplasmosis, an aortic aneurysm (bulging of a major artery that carries blood from the heart to the body), blood clots in the superior vena cava, enlargement of the thyroid gland, constrictive pericarditis (inflammation of the membrane surrounding the heart), or as a side effect of radiation therapy to the chest cavity may also be causes of obstruction.2

Common symptoms

The symptoms of superior vena cava obstruction may develop quickly or gradually. Early symptoms include swelling around the eye or face, particularly in the morning. Other common symptoms include shortness of breath and swelling of the face, neck, arms, or torso.

Less common symptoms

Occasionally, lung cancer patients may also experience dizziness, headache, visual disturbances, fainting, and redness of the face, palms, or mucus membranes (tissue that produces mucus that lines many inner parts of the body) in the nose or mouth.

Superior vena cava obstruction is serious, may be life-threatening, and requires immediate medical attention.1,2

How do doctors assess and diagnose swelling in the face and neck in lung cancer patients?

A physician may notice swelling of the face, neck, and upper chest during a physical examination. Additional imaging techniques used to diagnose superior vena cava obstruction include:

  • Bronchoscopy, a thin tube placed into the windpipe to view the lungs
  • Chest x-ray
  • CT (computed tomography) scan
  • MRI (magnetic resonance imaging)
  • Coronary angiography, which looks at the heart blood vessels
  • Ultrasound of the blood vessels
  • Radionuclide ventriculography, which studies the motion of the heart and surrounding vessels (may also be called a multiple-gated acquisition or MUGA scan)2

Treating superior vena cava obstruction

Treatment aims to relieve the blockage. In the case of lung cancer, tumors will be targeted using chemotherapy, radiation therapy, surgery, and targeted therapies.

Medications to reduce the swelling
Medications such as diuretics or steroids may temporarily reduce swelling. Sometimes, a stent (tiny tube placed in the vessel to keep it open) is placed in the superior vena cava.2

Other symptoms of lung cancer

In addition to a swelling of the face and neck, other symptoms of lung cancer include:

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